Abstract
BACKGROUND: The echocardiography is the first-line imaging modality in detecting the cardiac lipoma. Contrast-enhanced echocardiography improves its structural definition and characteristics of blood supply to exclude thrombus and malignant tumors. CASE PRESENTATION: We introduced a case that large cardiac mass involving nearly the whole left ventricular cavity and papillary muscles without any complications. Multimodal imaging has confirmed lipoma before surgery. However, rather than recommending conservative treatment in accordance with guidelines, surgical intervention was performed to prevent future hemodynamic abnormalities. CONCLUSION: Combined with multimodal imaging, we showed a rare case on comprehensive evaluation of left ventricular silent lipoma and provided new clues for surgical strategy, which were different from guideline recommendations.