Cardiac Tumor

What is a cardiac tumor?

A cardiac tumor is an abnormal growth of tissue in the heart, and may be classified as either cancerous (malignant) or non-cancerous (benign). Cardiac tumors are further classified as either primary (originating within the heart itself) or secondary (spread from a primary tumor in a different part of the body). Primary cardiac tumors are extremely rare, occurring in approximately 1 in 3000 individuals. Seventy-five percent of primary cardiac tumors are benign. Secondary cardiac tumors are 20-30 times more frequent than primary cardiac tumors and most commonly arise in patients with lung cancer, breast cancer, melanoma, renal cell cancer, or lymphoma.

What are the symptoms of a cardiac tumor?

Cardiac AmyloidMany patients with a cardiac tumor are asymptomatic (have no symptoms at all). For those patients that do have symptoms they are typically non-specific and similar to many other more common cardiovascular conditions. Symptom presentation depends primarily upon tumor location, size, growth rate, and friability (tendency to break off and travel in the blood stream).

Examples of clinical presentations include:

  • Heart failure (shortness of breath, leg swelling, inability to lie flat)
  • Arrhythmia (irregular heart beat)
  • Chest pain
  • Stroke (slurred speech, weakness, vision loss)
  • Pericardial effusion (fluid/blood/tumor within the sac that surrounds the heart)
  • Constitutional symptoms (fever, weight loss, elevated inflammatory markers, anemia)

How is a cardiac tumor detected?

Cardiac tumors are most commonly diagnosed by echocardiogram (cardiac ultrasound). Further non-invasive imaging with computed tomography (CT scan), magnetic resonance imaging (MRI), or positron emission tomography (PET scan) may help to better characterize/diagnose a cardiac tumor.

What are the different types of primary cardiac tumors?

Cardiac HemangiomaThe most common types of benign heart tumors are:

  • Myxoma – most common primary cardiac tumor. Account for approximately 50% of primary cardiac tumors.
  • Papillary fibroelastoma – most common cardiac tumor to affect the cardiac valves. Mean age at diagnosis is 60 years old. These tumors are associated with embolization (breaking off and traveling in the blood stream) resulting in stroke or less commonly heart attack.
  • Rhabdomyoma – most common cardiac tumor in infants and children. Typically multiple and originating from the ventricular wall. Associated Tuberous Sclerosis is seen in 1/3 of patients.
  • Fibroma – commonly occur in infants and children. Typically located within the ventricular wall. Associated with arrhythmia (irregular heart beat) and risk for sudden cardiac death.
  • Lipoma – tumor made up of fat cells. Diagnosis can be made non-invasively by cardiac MRI.
  • Hemangioma – tumor made of abnormal blood vessels. Diagnosis can be made either invasively on coronary angiography or non-invasively on cardiac CT or MRI.

AngiosarcomaNearly all primary malignant cardiac tumors are sarcomas, and the most frequent one is angiosarcoma. Angiosarcoma is a very aggressive form of cancer made up of abnormal blood vessels. It characteristically originates from the right atrium. The clinical course is rapid with a very high incidence of spread throughout the body (metastasis). Once the cancer has metastasized the prognosis is poor.