Best Cases: Cardiac Masses-Three-year Follow-up of Unresected Large Antero-Lateral Papillary Muscle Lipoma

Three-year Follow-up of Unresected Large Antero-Lateral Papillary Muscle Lipoma

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Video Summary

A 34-year-old asymptomatic woman undergoing dental clearance was found to have an incidental left ventricular mass. Cardiac MRI demonstrated a large fat-containing lipoma involving the anterolateral papillary muscle, with no enhancement or significant mitral regurgitation. Although surgery was recommended, she declined and chose close surveillance. On three-year follow-up MRI, the mass remained unchanged and she stayed asymptomatic. This case highlights the rarity of papillary muscle lipomas, especially unresected anterolateral lesions, and underscores the lack of clear guidelines for surgery or follow-up in stable asymptomatic patients.

Keywords

left ventricular mass

papillary muscle lipoma

cardiac MRI

asymptomatic patient

surveillance