A case with a giant interatrial septal lipomatous hypertrophy, and thickened epicardial and visceral fat: Different faces of a common metabolic problem?

Interatrial septal lipomatous hypertrophy (ISLH) is a rare benign disorder characterized by fat deposition in the interatrial septum. It is an uncapsulated smooth mass that should be considered in the differential diagnosis of atrial masses. It is usually observed in the elderly and obese people, and it is more common in women than in men (1). Although arrhythmia and symptoms due to obstruction related to ISHL have been reported, it is usually asymptomatic and diagnosed incidentally. In many cases, diagnosis can be made by echocardiograpy alone if the mass has a typical appearance. Otherwise, multislice computed tomography (MSCT) or magnetic resonance imaging (MRI) may be required to determine the fat content. Here, we report a case with a giant ISLH occupying the right atrial cavity along with a highly thickened epicardial and abdominal visceral fat tissue, suggesting that all of them may be a different presentations of a common metabolic problem.