Primary Tumors of the Heart

Cardiac rhabdomyoma in the right ventricle of a three year old girl. She was presenting with a heart murmur on the outside

Cardiac myxoma: a gelatinous tumor that almost completely fills the left atrium.

Cardiac myxoma: a 71 year old man hospitalized for TIA; trans-esophageal echocardiography revealed cardiac myxoma in the left atrium

Embolus of cardiac myxoma in bifurcation of common iliac artery.

Primary heart tumors are significantly less common than secondary tumors

Benign Tumors

Benign tumors of the heart include:

Papillary Fibroelastoma

Warty or tassel-like formation on the heart valves.

Cardiac Myxoma

In 80% of cases, it is located in the left atrium, in 15% of the cases in the right atrium. The remaining 5% are located in the left or right ventricles.

Clinical Signs

• In case of embolism: ischemia of organs supplied by the embolized artery
• In case of mitral obstruction: dyspnea, fatigue, cough, hemoptysis, pulmonary edema
• In case of tricuspid obstruction: symptoms of right-sided heart failure

Cardiac myxoma can be accompanied by a variety of non-specific symptoms

Diagnostics

• Patient's history
• Physical examination
• Echocardiography

Treatment

• Surgical removal
• Echocardiographic monitoring

Carney Complex

= syndrome of complex myxoma

• This is a rare syndrome in which cardiac myxoma is associated with:
  • Multiple pigmented nevi
  • Adrenocortical hyperplasia
  • Pituitary tumors
  • Multiple fibroadenomas of breasts
  • Sertoli cell tumor
  • Skin myxoma

Rhabdomyoma

 For more information see Rhabdomyoma.

Malignant Tumors

Sarcomas

• Angiosarcoma, rhabdomyosarcoma (fibrosarcoma, liposarcoma, osteosarcoma)
• It can occur at any age
• Most often in the myocardium of the right atrium
• Clinical notes: it can manifest as heart failure, arrhythmia, pain in the precordium, pericardial effusion, cardiac tamponade, sudden cardiac death, embolization (tumor masses, thrombi; often to the CNS), pulmonary edema, and/or syncope (when the tumor is located in left atrium); extracardiac metastases (lung, mediastinum, spine, etc.); prognosis is very poor (about 3 months of life).
• Diagnostics: weight loss, blobbing fingers, heart failure, arrhythmia, pericardial friction murmur, diastolic murmur at the tip/regurgitation systolic murmur; mainly ECHO, CT, and MRI.
• Treatment: surgical removal, but in most cases it is only palliative

References

Related Pages

• Heart tumors

Sources

• KLENER, P, et al. Internal Medicine. 3rd edition. Prague: Galén, 2006.  ISBN 80-7262-430-X .
• VANĚK, Ivan. Kardiovaskulární chirurgie. 1. edition. Praha : Karolinum, 2003. 236 pp. ISBN 8024605236.