Diagnosis of Epipericardial Fat Necrosis on multimodality imaging in a pediatric patient: a case report and review of the literature

J Radiol Case Rep. 2020 May 31;14(5):16-24. doi: 10.3941/jrcr.v14i5.3971. eCollection 2020 May.

Abstract

This is a case report of a 13-year-old male, presented to the Emergency Department complaining of a sudden onset left-sided pleuritic chest pain for 1 day. He was found to have a mass in the left Epipericardial fat with fat stranding and pleural effusion supporting the diagnosis of Epipericardial Fat Necrosis. The findings were established by Computed tomography and Ultrasound, and the final diagnosis was confirmed by Magnetic resonance imaging. Subsequently, the patient was discharged on analgesia; reassessment one-month later showed clinical improvement with no symptom recurrence. Repeated Ultrasound demonstrated a marked decrease in size and echogenicity of the mass. In this paper we review the clinical and radiological manifestations of Epipericardial fat necrosis and the different management approaches taken over the years.

Keywords: Computed Tomography; Epipericardial fat necrosis; Magnetic Resonance Imaging; Ultrasound; pediatrics; pericardium; pleuritic chest pain.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Chest Pain
  • Diagnosis, Differential
  • Emergency Service, Hospital
  • Fat Necrosis* / diagnosis
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Multimodal Imaging
  • Pain Management
  • Pericardium* / diagnostic imaging
  • Pericardium* / pathology
  • Pleural Effusion
  • Recurrence
  • Tomography, X-Ray Computed / methods
  • Ultrasonography