Giant pericardial lipoma: unusual cause of intrathoracic mass.

INTRODUCTION Pericardial lipomas are rare clinical findings. We describe a case of pericardial/epicardial lipoma seen recently at our hospital. CLINICAL PICTURE A 68-year-old lady presented with a 1-year history of dull aching upper abdominal pain. A chest X-ray revealed a large mass lesion in the right hemithorax. Computed tomography (CT) scan of the chest defined the nature of the lesion. CT-guided fine needle aspiration cytology showed mature fat cells. TREATMENT The large lipoma (19 x 10 x 4 cm, 1500 g) was completely excised along with a block of the parietal pericardium; through standard right posterolateral thoracotomy. OUTCOME The patient had an uneventful postoperative recovery. She is currently asymptomatic and has no evidence of recurrence at 18 months follow-up. CONCLUSION Lipomas in the thoracic cavity are rare and pericardial lipomas even rarer. These are best identified on imaging studies including a CT scan. Complete surgical excision of the lipoma is the only mode of treatment and adequate surgery the only way to prevent future recurrences.