An epicardial problem case report: multimodality imaging assessment of a patient presenting with symptomatic ventricular tachycardia, secondary to a large, epicardial, lipomatous mass with myocardial infiltration.

Background: Cardiac lipomas are considered benign and slow-growing adipose tissue tumours; however, the size and location can cause significant haemodynamic compromise and therefore can be malignant in clinical presentation.

Case summary: The clinical case describes a rare presentation of a 50-year-old patient, presenting with recurrent haemodynamically compromising ventricular arrhythmia; secondary to an incredibly large, epicardial lipomatous mass, with associated combination of myocardial infiltration, left ventricular systolic impairment, and complex cardiac circulatory involvement.

Discussion: The case illustrates the ESC guidelines on the benefits of complimentary multimodality cardiac imaging to assess complex pericardial disease, to improve both clinical understanding and management.