Giant Cardiac Lipoma in the Ventricular Septum Involving the Tricuspid Valve Hiroyuki Nishi, MD, Masataka Mitsuno, MD, Masaaki Ryomoto, MD, Hiroyuki Hao,

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Giant Cardiac Lipoma in the Ventricular Septum Involving the Tricuspid Valve Hiroyuki Nishi, MD, Masataka Mitsuno, MD, Masaaki Ryomoto, MD, Hiroyuki Hao, MD, Seiichi Hirota, MD, Yuji Miyamoto, MD The Annals of Thoracic Surgery Volume 88, Issue 4, Pages 1337-1339 (October 2009) DOI: 10.1016/j.athoracsur.2009.02.052 Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (a) Preoperative enhanced computed tomographic scan showed 5-cm diameter tumor, which had a broad-based attachment to the right side of the interventricular septum. (b) The tumor was seen through a right atrium incision. The lobulated yellowish mass was broadly attached on the ventricular septum and occupied the right ventricular cavity (white arrow). (c) A postoperative enhanced computed tomographic scan revealed volume reduction of the tumor. (d) After resection of the tumor with the septal leaflet of the tricuspid valve, ventricular septum (blue arrow) was seen. The remaining tumor was integrated with the ventricular septum and was also partly immersed into it. The Annals of Thoracic Surgery 2009 88, 1337-1339DOI: (10.1016/j.athoracsur.2009.02.052) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (a) Gross appearance of surgically resected part of lipoma with the septal leaflet of the tricuspid valve and part of the chordae and papillary muscles. (b) The tumor was removed in pieces, and involvement of chordae and papillary muscle of tricuspid valve is evident. Microphotograph showing surface area of the tumor composed of mature adipose cells. Inset indicates high-power view of adipose cells without malignant features. (c) Muscle cells were encountered by mature adipose tissue. (d) The histologic feature of infiltrating adipose tissue was dominant in the removed tumor. A few adipose tissues were infiltrated into the chordae of the tricuspid valve. [(b–d) Hematoxylin & eosin; bars, 500 μm. (b) Inset: Hematoxylin & eosin; bar, 50 μm.] The Annals of Thoracic Surgery 2009 88, 1337-1339DOI: (10.1016/j.athoracsur.2009.02.052) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions