Unexpected transesophageal echocardiography tee finding: mediastinal lipomatosis fakes an aortic intramural haematoma

Mediastinal lipomatosis (ML) is a benign condition characterized by accumulation of fatty tissue. This condition is usually related to spontaneous or iatrogenic corticosteroid-induced Cushing syndrome or to obesity (1). Although it is an asymptomatic disorder, it can rarely result in compression of adjacent organs with thoracic pain, dyspnea, cough, dysphonia, and dysphagia. In this report we describe a case of fatty infiltration around descending aortic wall in a patient with autoimmune disorders, dilated cardiomyopathy and mitral insufficiency, simulating an intramural hematoma (IMH).