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Left Ventricular Lipomatous Hamartoma Mimicking a Calcified Amorphous Tumor.

A 56-year-old Japanese woman with type 1 diabetes mellitus for 20 years was referred for echocardiographic examination for a systolic ejection murmur. She had been undergoing hemodialysis for 10 years because of diabetic nephropathy, along with other diabetic complications, including proliferative retinopathy and neuropathy. She had a normal ECG, and her cardiothoracic ratio was 52% on chest x-ray. Laboratory examination showed poor control of blood sugar (casual blood glucose, 256 mg/dL; hemoglobin A1c, 9.3%) and renal dysfunction (blood urea nitrogen, 49 mg/dL [institutional normal range, 8–20 mg/dL]; creatinine, 8.5 mg/dL [institutional normal range for women, 0.4–0.9 mg/dL]), and her serum brain natriuretic peptide level was 48.4 pg/mL (institutional upper limit, 18.4 pg/mL). There was no evidence of infectious endocarditis.

Transthoracic echocardiography showed normal left ventricular (LV) size and normal systolic function with a slightly dilated left atrium. We found a mobile rod-like structure (5×20 mm) in the LV outflow tract (Figure 1A and Movie IA in the online-only Data Supplement), which had not been …