Mediastinal Lipoma: An Unusual Cause of Progressive Dyspnea

Misha A Khan; Yash B Patel; Karldon I Nwaezeapu; Mohammed H El Nayir; Robert C Lyons; Tauqir Y Goraya

doi:10.1016/j.jaccas.2025.104426

Mediastinal Lipoma: An Unusual Cause of Progressive Dyspnea

JACC Case Rep. 2025 Aug 6;30(22):104426. doi: 10.1016/j.jaccas.2025.104426.

Authors

Misha A Khan¹, Yash B Patel², Karldon I Nwaezeapu², Mohammed H El Nayir², Robert C Lyons³, Tauqir Y Goraya⁴

Affiliations

¹ Department of Internal Medicine, Trinity Health Ann Arbor, Ann Arbor, Michigan, USA. Electronic address: Misha.Khan@trinity-health.org.
² Department of Internal Medicine, Trinity Health Ann Arbor, Ann Arbor, Michigan, USA.
³ Section of Cardiothoracic Surgery, Department of Surgery, Trinity Health Ann Arbor, Ann Arbor, Michigan, USA.
⁴ Section of Cardiology, Department of Internal Medicine, Trinity Health Michigan Heart Ann Arbor, Ann Arbor, Michigan, USA.

Abstract

Background: Mediastinal lipomas, while rare, can present with progressive dyspnea.

Case summary: Our case describes a 62-year-old woman presenting with slowly progressive exertional dyspnea over the course of 2 years with a largely unremarkable initial cardiac and pulmonary evaluation. Advanced imaging ultimately revealed a large mediastinal lipoma causing a compressive effect on her left atrium and pulmonary veins.

Discussion: This case highlights the importance of considering structural lesions within the mediastinum in the differential diagnosis of exertional dyspnea, particularly when conventional cardiac and pulmonary evaluations fail to elucidate the underlying etiology.

Take-home messages: Structural lesions, such as slow-growing mediastinal tumors, can cause long-standing progressive exertional dyspnea through mechanical compression of vital structures in the thoracic cavity. Once symptomatic, surgical resection results in symptomatic relief and is curative.

Keywords: mediastinal lipoma; surgical resection.

Publication types

Case Reports