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Lipoma near heart, had cervical cancer. Weakness, dyspnea, aneurysm. Family history of aneurysm. Shall I do something?

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Cardiologist, Interventional
Practicing since : 1998
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I have a two-lobed lipoma, situated between both the upper and lower chambers of my heart.One lobe is six cm and the other 4cm. Both lobes are ca 2,5 cm wide. I'm 70 years old, and the lipoma was detected with MRT when I was checked after hysterectemia (cancer cervix). I have now been to visit a cardiologist twice With one years interval. She does not want to do anything: Welcome back next year. In the meantime a get weaker and weaker, have dyspnea and help to move about. I also have aneurysm on aorta, size 3 cm. My father died of his aneurysm. Shall i do something?
Posted Tue, 8 May 2012 in Hypertension and Heart Disease
Answered by Dr. Prabhakar C Koregol 7 hours later

Thank you for posting the query.

Your reports are not clear. It looks like lipoma should be outside heart and in mediastinum and in that case it may need treatment and may not be cause for your symptoms.

Secondly aneurysm size of 3cm? We usually call aorta as aneurysmal only after 5-5.5cm depending on the location.

Please recheck that report also and get back to me with detailed reports and images.

You have a feature to upload the reports / image by yourself at the right side of the query page, please utilize that so that I can answer your queries better.

Awaiting your response.

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Follow-up: Lipoma near heart, had cervical cancer. Weakness, dyspnea, aneurysm. Family history of aneurysm. Shall I do something? 8 hours later
The two-lobed lipoma is situated between both ventricels and both atria. They are partly overlapping. They are not situated in the heart sack, but a minor accumulation of fluid is there. I citate from the first MR. "Generally some more subepicardial fat around the heart and the large vessels. There is a homogenous lobulating, benignlooking process, with connection to the atrial septum with two large lobes. The cranial lobe measures around 5 cm craniocaudally and 3,5 x 2,6 cm in cross section and the caudal lobe measures around 40 mm craniocaudally and 27 x 26 mm in cross section. The above mentioned processes are situated in connection to vena cava superior and vena cava inferior at it's entrance. No turbulent flow is seen in functional pictures. No pathological uptake from contrast within the lipomatous mass at the sequented perfusion. Small amount of subepicardial fluid outside right chamber. Increased amount of fat outside the free wall in right chamber and basically at the AV-furrrow. No enlarged glands. No metstases of the lungs." MR taken 17th of dec 2010. I have dyspnea, arriving as soon as I do something. I walk with rollator outside. I manage 75 m then I must sit down and rest. Now and then I have a pain in the chest, starting in between my breasts and going leftwards. It is feels more at the backside than the front. When reading on the net they say operate lipomas in the heart.
Answered by Dr. Prabhakar C Koregol 37 minutes later

Thanks for providing me the details of the MRI.

After having reviewed your history and the MRI reports, my opinion is as follows:

The lipoma specified in the report is located critically and surgical removal may cause more harm. Further the symptoms of dysnea and chest pain that you have are unlikely to be caused by these lipoma.

Hence I agree with your cardiologist that there is no real indication to surgically remove the lipoma.

The symptoms that you describe are not be related to a cardiac condition. Perhaps a detailed evaluation of other pulmonary and systemic causes by your physician can be able to identify the real cause.

The bottom line is "Cardiac lipoma such as yours is a harmless condition. As they are located critically one should not attempt to remove it surgically".

Hope I have provided you with useful information. Please do accept the answer if you do not have any further queries.

Above answer was peer-reviewed by
Follow-up: Lipoma near heart, had cervical cancer. Weakness, dyspnea, aneurysm. Family history of aneurysm. Shall I do something? 27 hours later
What happens if it grows? Chest X-ray May 2010 showed normal heart size and normal lungs. Has it something to do with the fact that I after the operation got severe lymfoedemas in the legs? These have been properly treated and I visit physioterapeut once every fortnight. She works with my swelling belly as well as the legs.
Answered by Dr. Prabhakar C Koregol 1 hour later

Thanks for writing back.

If it grows marginally nothing would happen. If it grows significantly it can cause pressure on many of surrounding structures such as heart, food pipe or tarchea. In which case it need to be operated.

Hope I answered your query completely.

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