Intravascular lipoma of the brachiocephalic vein

Case contributed by Tiffany Fung

Presentation

Patient presenting for routine metastatic workup.

Patient Data

Age: 70 years
Gender: Male

There is a well-circumscribed hypodense lesion measuring 10 x 8 mm located in the left brachiocephalic vein. The region of interest over the intravascular lesion demonstrates internal fat densities similar to that of the subcutaneous tissue, in keeping with an intravascular lipoma.

Region of interest over the intravascular lesion demonstrates fat density similar to that of the subcutaneous tissue. 

Case Discussion

This is a case of an incidental intravascular lipoma of the left brachiocephalic vein

Lipomas often measure between -65 and -120 HU, resembling the density of subcutaneous fatty tissue.  While soft tissue lipomas are a very common entity, primary intravascular lipomas are extremely rare. Many benign primary venous tumors are asymptomatic and discovered incidentally. However, symptomatic intravascular tumors such as lipomas can present with obstructive symptoms secondary to their compressive effect. The most common intravascular lipomas have been described in the inferior vena cava. 

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