Tumors

Benigne

Usually, a cardiac tumor is benign in nature. A benign tumor has a good prognosis, but thrombi, vegetations and some tumors is embolization the main risk.

Primary benigne cardiac tumor

Tumor	Description	Location	Size
Myxoma	Most common primary cardiac tumor (50-75%).	90% atrial (LA 75%), 7% ventricular.	1-15cm (usually 5-6cm).
Fibroma	Second most common primary cardiac tumor.	Almost always ventricular (septal or apical).	± 10cm.
Papillair fibroelastoma	Most common valve tumor.	Whole heart, usually aortic valve (35%).	± 1cm.
Lipoma	Usually, on the basis of the endocardium.	Whole heart including valves and pericardium.	Up to ± 10 cm.
Rhabdomyoma	Most common benign cardiac tumor in children.	Mostly ventricular, no valve involvement.	1mm-9cm.
Hemangioma	Blood tumor, proliferation of endothelial cells.	Whole heart
Lambl's excrescences	Valvular piece of string	Ventricular side aortic valve.	± 1cm
Cysts	Congenital unnatural body cavity lined with epithelium.	Usually in the right atrium (right cardiofrenische corner).
Thrombi	Clots of blood by slow blood flow.	Left atrial appendage with atrial fibrillation
		akinetic myocardial infarction
		cardiomyopathies
		prosthetic valves/infectious valves
		atrial septal ASD / PFO

Myxoom LA

Myxoma LA

Fibroelastoom

Papillar fibroelastoma proximal septum

Maligne

Primary malignant tumors are very rare. Most common malignant cardiac tumors are secondary tumors derived from primary diseases (see below). 3% of all patients with cancer receive cardiac metastases through the four “pathways”: direct infitration, haematogenically (through blood), lymphatic and vessels (IVC, pulmonary veins). Malignant tumors have a poor prognosis: In malignant tumors the main risk is the malignancy itself.

Primary malignant cardiac tumor

Tumor	Description	Location
Angiosarcoma	Most common primary malignant cardiac tumor	90% Right atrium
Rhabdomyosarcoma	Second most common primary malignant cardiac tumor, often in children than adults	Whole heart
Mesothelioma	Covering visceral and parietal pericardium, no growth in endocardial.

Secundary maligne cardiac tumor

Location	Tumor
Left atrium	Myxoma
	Thrombus
	Papillary fibroelastoma
	Sarcoma
Right atrium	Myxoma
	Angiosarcoma
	Lymphoma
	Thrombus
	Papillair fibroelastoma
Left ventricle	Fibroma
	Rhobdomyoma
	Thrombus
	Papillair fibroelastoma
Right ventricle	Fibroma
	Rhabdomyoma
	Angiosarcoma
	Lymphoma
	Thrombus
	Papillair fibroelastoma

References

Eur J Echocardiogr. 2010 Jul;11(6):461-7

Am Heart J. 2003 Sep;146(3):404-1

J Am Soc Echocardiogr. 2000 Dec;13(12):1080-3.

Rev Chir Orthop Reparatrice Appar Mot. 2000 May;86(3):293-9.