Tumor

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

TumorDescriptionLocationSize
MyxomaMost common primary cardiac tumor (50-75%).90% atrial (LA 75%), 7% ventricular.1-15cm (usually 5-6cm).
FibromaSecond most common primary cardiac tumor.Almost always ventricular (septal or apical).± 10cm.
Papillair fibroelastomaMost 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.
RhabdomyomaMost common benign cardiac tumor in children.Mostly ventricular, no valve involvement.1mm-9cm.
HemangiomaBlood tumor, proliferation of endothelial cells.Whole heart
Lambl's excrescencesValvular piece of stringVentricular side aortic valve.± 1cm
CystsCongenital unnatural body cavity lined with epithelium.Usually in the right atrium (right cardiofrenische corner).
ThrombiClots 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

TumorDescriptionLocation
AngiosarcomaMost common primary malignant cardiac tumor90% Right atrium
RhabdomyosarcomaSecond most common primary malignant cardiac tumor, often in children than adultsWhole heart
MesotheliomaCovering 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

LocationTumor
Left atriumMyxoma
Thrombus
Papillary fibroelastoma
Sarcoma
Right atriumMyxoma
Angiosarcoma
Lymphoma
Thrombus
Papillair fibroelastoma
Left ventricleFibroma
Rhobdomyoma
Thrombus
Papillair fibroelastoma
Right ventricleFibroma
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.