Spontaneous regression of epipericardial fat necrosis

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  • 自然経過で縮小を認め心膜周囲脂肪壊死と診断した1例

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<p>We herein report a case of epipericardial fat necrosis (EFN) showing spontaneous regression. A 50-year-old woman was admitted to the emergency department of a nearby hospital due to the sudden onset of pleuritic pain, but the cause could not be identified. Chest CT performed six days after the onset at the second hospital revealed an ovoid lesion with fat attenuation surrounded by a thick rim inside the left epipericardial fat, accompanied by pleural effusion and pericardial thickening. These findings led to examination for inflammatory processes such as pleuritis. On chest CT performed nine days after the onset, the encapsulated fat-density mass remained without any marked changes except for the disappearance of pleural effusion. Follow-up CT performed four weeks after the onset demonstrated resolution of the epipericardial fat lesion. Clinical and serial CT findings, together with the benign and self-limited nature, were consistent with the diagnosis of EFN. EFN is a self-limited disease, and conservative treatment is indicated. However, the lack of information on this clinical entity might contribute to underdiagnosis. Awareness of these clinical features is important to make a correct diagnosis and avoid unnecessary surgical interventions.</p>

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