Intramyocardial Lipoma of the Left Ventricle: A Diagnostic Conundrum Solved with Multimodality Imaging

Intramyocardial lipomas are rare benign cardiac tumors that often present a diagnostic dilemma due to their nonspecific clinical and imaging features on initial evaluation. We report the case of a 40-year-old asymptomatic male who presented with a large intramyocardial lipoma arising from the basal inferior wall of the left ventricle. Initial transthoracic echocardiography revealed an echogenic mass in the region of the left ventricle basal septum but was insufficient for definite characterization. Cross-sectional imaging, including computed tomography (CT) and cardiac magnetic resonance imaging (MRI), demonstrated a homogeneous fat-density mass consistent with lipoma. This case highlights the pivotal role of multimodality imaging in accurately characterizing a rare primary cardiac tumor.