{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T06:59:58Z","timestamp":1791874798488,"version":"4.3.4"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T00:00:00Z","timestamp":1709856000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T00:00:00Z","timestamp":1709856000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["surg case rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Epipericardial fat necrosis (EFN) is a rare disease in which local inflammation and necrosis occur in the adipose tissue surrounding the heart, particularly epicardial fat. Few cases of EFN in which surgical resection was performed have been reported. We report a case of EFN after surgical resection of a right extrapulmonary tumor, in which a malignant disease could not be excluded.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 75-year-old male patient presented with fever and chest pain. A contrast-enhanced computed tomography scan of the chest revealed a lesion, 53\u2009\u00d7\u200948\u00a0mm in size, with mixed fatty density spanning the middle and lower lobes of the right lung. Thoracic magnetic resonance imaging (MRI) revealed a mass with mixed fat and soft tissue density in the same area; the lesion was contiguous with pericardial fatty tissue. The tumor was diagnosed as a liposarcoma or teratocarcinoma based on imaging results; however, the possibility of lung cancer could not be excluded. Finally, EFN was diagnosed based on the postoperative histopathological examination. The patient underwent surgical resection of the suspected right extrapulmonary tumor. The intraoperative findings revealed a mediastinal mass contiguous with pericardial fat located between the middle and lower lobes. Intraoperative pathological examination of the lesion was performed using a needle biopsy; however, no definitive diagnosis was made. The tumor may have invaded the middle lobe of the right lung, and partial resection of the right lower lobe was performed in addition to resection of the middle lobe of the right lung. The patient was followed up every 3\u00a0months without adjuvant therapy. No recurrence was reported at 1\u00a0year after surgery.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>EFN should be considered in the differential diagnosis of an extrapulmonary tumor when continuity with the pericardial space is observed on MRI or other imaging studies. Surgical resection is useful in the diagnosis and treatment of EFNs. Preoperative three-dimensional reconstructive imaging and MRI should be used to identify vascular structures and confirm the continuity of the lesion with the surrounding tissues to ensure safe and rapid tumor removal.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40792-024-01859-0","type":"journal-article","created":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T03:02:13Z","timestamp":1709866933000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Ectopic epipericardial fat necrosis: a case report"],"prefix":"10.1186","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6904-7267","authenticated-orcid":false,"given":"Ryusei","family":"Yoshino","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaki","family":"Nakatsubo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nanami","family":"Ujiie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akane","family":"Ito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nana","family":"Yoshida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoko","family":"Aoki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Kitada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,3,8]]},"reference":[{"key":"1859_CR1","doi-asserted-by":"publisher","first-page":"003823","DOI":"10.12890\/2023_003823","volume":"10","author":"Y Otaka","year":"2023","unstructured":"Otaka Y, Harada Y, Kawamura R, Shimizu T. Epipericardial fat necrosis. Eur J Case Rep Intern Med. 2023;10:003823. https:\/\/doi.org\/10.12890\/2023_003823.","journal-title":"Eur J Case Rep Intern Med."},{"key":"1859_CR2","doi-asserted-by":"publisher","first-page":"2427","DOI":"10.2169\/internalmedicine.8161-21","volume":"61","author":"S Kumei","year":"2022","unstructured":"Kumei S, Ishitoya S, Oya A, Ohhira M, Ishioh M, Okumura T. Epipericardial fat necrosis: a retrospective analysis in Japan. Intern Med. 2022;61:2427\u201330. https:\/\/doi.org\/10.2169\/internalmedicine.8161-21.","journal-title":"Intern Med"},{"key":"1859_CR3","doi-asserted-by":"publisher","first-page":"16","DOI":"10.3941\/jrcr.v14i5.3971","volume":"14","author":"L Alomari","year":"2020","unstructured":"Alomari L, Khushaim A. 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;14:16\u201324. https:\/\/doi.org\/10.3941\/jrcr.v14i5.3971.","journal-title":"J Radiol Case Rep"},{"key":"1859_CR4","doi-asserted-by":"publisher","first-page":"117954762094076","DOI":"10.1177\/1179547620940769","volume":"13","author":"SG Mortensen","year":"2020","unstructured":"Mortensen SG, Buchmann P, Lappeg\u00e5rd KT. Epipericardial fat necrosis: a case report and a review of the literature. Clin Med Insights Case Rep. 2020;13:1179547620940769. https:\/\/doi.org\/10.1177\/1179547620940769.","journal-title":"Clin Med Insights Case Rep"},{"key":"1859_CR5","doi-asserted-by":"publisher","first-page":"1451","DOI":"10.1111\/ajt.15744","volume":"20","author":"CRF Cafezeiro","year":"2020","unstructured":"Cafezeiro CRF, Lopes MP, Silva CT, \u00c1vila MS, Seguro LFBC, Mangini S, et al. Epipericardial fat necrosis as cause of chest pain in patient after heart transplantation. Am J Transplant. 2020;20:1451\u20133. https:\/\/doi.org\/10.1111\/ajt.15744.","journal-title":"Am J Transplant"},{"key":"1859_CR6","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1007\/s00247-019-04531-0","volume":"50","author":"M Artunduaga","year":"2020","unstructured":"Artunduaga M, Fuqua BL, Pierry C, Soto Giordani GA, Roman-Colon AM. Imaging diagnosis of epipericardial fat necrosis in children. Pediatr Radiol. 2020;50:285\u20138. https:\/\/doi.org\/10.1007\/s00247-019-04531-0.","journal-title":"Pediatr Radiol"},{"key":"1859_CR7","doi-asserted-by":"publisher","first-page":"e205","DOI":"10.1097\/j.pbj.0000000000000205","volume":"8","author":"ML Matos","year":"2023","unstructured":"Matos ML, Matias PCF, Grij\u00f3 CMSPM, Gouveia RB, Patacho MFS, Almeida AJS. Epipericardial fat necrosis: a case report of an underdiagnosed disease. Porto Biomed J. 2023;8:e205. https:\/\/doi.org\/10.1097\/j.pbj.0000000000000205.","journal-title":"Porto Biomed J"},{"key":"1859_CR8","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1186\/s12872-023-03349-x","volume":"23","author":"I Barreto","year":"2023","unstructured":"Barreto I, Oliveira FG, Barreira SC, In\u00e1cio JR. Epipericardial fat necrosis in chest CT and MRI: a case report of an unusual cause of chest pain associated with the initial diagnosis of undifferentiated connective tissue disease. BMC Cardiovasc Disord. 2023;23:314. https:\/\/doi.org\/10.1186\/s12872-023-03349-x.","journal-title":"BMC Cardiovasc Disord"},{"key":"1859_CR9","doi-asserted-by":"publisher","first-page":"e259","DOI":"10.1016\/j.athoracsur.2021.06.013","volume":"113","author":"T Utsumi","year":"2022","unstructured":"Utsumi T, Saito T, Honda O, Ishida M, Maru N, Matsui H, et al. Right epipericardial fat necrosis after thymectomy. Ann Thorac Surg. 2022;113:e259\u201361. https:\/\/doi.org\/10.1016\/j.athoracsur.2021.06.013.","journal-title":"Ann Thorac Surg"},{"key":"1859_CR10","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1111\/1754-9485.13562","volume":"67","author":"SK Kenyon","year":"2023","unstructured":"Kenyon SK, Wijesekera VA, Wesley AJ. Case report on the radiographic features of epipericardial fat necrosis in a patient presenting with acute chest pain. J Med Imaging Radiat Oncol. 2023;67:509\u201313. https:\/\/doi.org\/10.1111\/1754-9485.13562.","journal-title":"J Med Imaging Radiat Oncol"},{"key":"1859_CR11","doi-asserted-by":"publisher","first-page":"eRC0183","DOI":"10.31744\/einstein_journal\/2023RC0183","volume":"21","author":"TAD Accorsi","year":"2023","unstructured":"Accorsi TAD, Paix\u00e3o MR, Piorino EMS, Amicis K, K\u00f6hler KF, Souza JL Jr. Epipericardial fat necrosis as a differential diagnosis of acute chest pain: a case report and algorithm proposal for diagnostic approach. Einstein (S\u00e3o Paulo). 2023;21:eRC0183. https:\/\/doi.org\/10.31744\/einstein_journal\/2023RC0183.","journal-title":"Einstein (S\u00e3o Paulo)"},{"key":"1859_CR12","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1111\/echo.14571","volume":"37","author":"A Neto","year":"2020","unstructured":"Neto A, Seabra D, Moreno N, Magalh\u00e3es S, Pires L, Pinto P. Epipericardial fat necrosis as a differential diagnosis of chest pain-a case report. Echocardiography. 2020;37:132\u20134. https:\/\/doi.org\/10.1111\/echo.14571.","journal-title":"Echocardiography"},{"key":"1859_CR13","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1093\/ehjcr\/ytab529","volume":"6","author":"FMA van de Heuvel","year":"2022","unstructured":"van de Heuvel FMA, Dimitriu-Leen AC, Habets J, Nijveldt R. Case report: epipericardial fat necrosis-a rare cause of chest pain. Eur Heart J Case Rep. 2022;6:529. https:\/\/doi.org\/10.1093\/ehjcr\/ytab529.","journal-title":"Eur Heart J Case Rep"},{"key":"1859_CR14","doi-asserted-by":"publisher","first-page":"1160","DOI":"10.3348\/jksr.2021.0157","volume":"83","author":"SJ Kim","year":"2022","unstructured":"Kim SJ, Han BH, Cho Y, Ryu DS, Yoon GY, Paik W, et al. Epipericardial fat necrosis in a pediatric patient diagnosed using contrast-enhanced MRI findings: a case report and literature review. J Korean Soc Radiol. 2022;83:1160\u20137. https:\/\/doi.org\/10.3348\/jksr.2021.0157.","journal-title":"J Korean Soc Radiol"},{"key":"1859_CR15","doi-asserted-by":"publisher","first-page":"2488","DOI":"10.1016\/j.radcr.2022.04.013","volume":"17","author":"MJ Rafiee","year":"2022","unstructured":"Rafiee MJ, Khaki M, Haririsanati L, Fard FB, Chetrit M, Friedrich MG. MRI findings of epipericardial fat necrosis: as a rare cause of acute chest pain in a healthy man. Radiol Case Rep. 2022;17:2488\u201391. https:\/\/doi.org\/10.1016\/j.radcr.2022.04.013.","journal-title":"Radiol Case Rep"}],"container-title":["Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-024-01859-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40792-024-01859-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-024-01859-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T03:05:14Z","timestamp":1709867114000},"score":1,"resource":{"primary":{"URL":"https:\/\/surgicalcasereports.springeropen.com\/articles\/10.1186\/s40792-024-01859-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,8]]},"references-count":15,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["1859"],"URL":"https:\/\/doi.org\/10.1186\/s40792-024-01859-0","relation":{},"ISSN":["2198-7793"],"issn-type":[{"value":"2198-7793","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,8]]},"assertion":[{"value":"26 September 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 March 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 March 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted in accordance with the guidelines of the Declaration of Helsinki and was approved by the Institutional Review Board of Asahikawa Medical University Hospital (No. 23041). Approval date: June 28, 2023. Written informed consent was obtained from the patient to publish this paper.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for the publication of this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors have no competing interests, financial or non-financial.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"54"}}