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 |
Myxoma LA
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
| Metastases |
|---|
| Melanoma |
| Lung cancer |
| Breast cancer |
| Sarcoma |
| Renal cell carcinoma |
| Leukemia |
| Lymphoma |
| Esophagus cancer |
| Hepatocellular carcinoma |
| Thyroid cancer |
Location of most common cardiac tumors
| 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.