A case of epipericardial fat necrosis

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  • Sakamaki Hiroyuki
    Department of Thoracic Surgery, Japanese Red Cross Ashikaga Hospital
  • Oka Naoyuki
    Department of Thoracic Surgery, Japanese Red Cross Ashikaga Hospital
  • Hashimoto Kohei
    Department of Thoracic Surgery, Japanese Red Cross Ashikaga Hospital

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  • Epipericardial fat necrosisの一切除例

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<p>Background: Epipericardial fat necrosis (EFN) is a rare benign disorder where the epipericardial fat pad develops necrotic change without any clear cause. The etiology is unknown.</p><p>Case: A 65-year-old male presented with chest pain. Chest computed tomography showed a 6-cm mass in the anterior mediastinum. He showed strong signs of inflammation based on a blood test. Chest magnetic resonance imaging revealed that the mass was well-capsulated, containing fat tissue with edematous change and accompanied with inflammatory changes in the surrounding structures. In a previous CT performed 5 years ago, there was no abnormality in the anterior mediastinum. He underwent surgery to confirm the diagnosis as malignancy could not be excluded. The mass was strongly adhesive to the right lung and pericardium, which were partially resected together. Conversion from a thoracoscopic to open approach was necessary because of these strong adhesions. There were no complications. The patient was discharged on the 10th day after surgery. Chest pain and serum inflammatory signs resolved postoperatively. Microscopically, the mass consisted of fat tissue with necrotic change. In combination with the clinical course, the mass was diagnosed as epipericardial fat necrosis.</p><p>Conclusion: We report the case of a rare disease, epipericardial fat necrosis, involving a patient presenting with chest pain.</p>

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