What is the most common type of primary cardiac tumor?

Benign myxoma. Most frequently, these arise in the left atrium, where auscultation may reveal a âœtumor plop’ ‘ in diastole as the tumor hits the ventricular wall. Myxomas usually are sporadic but can be familial with autosomal-dominant inheritance. Features of familial syndromes include pigmented nevi, nodular disease of the adrenal cortex, mammary fibroadenomas, and testicular or pituitary tumors.

What primary malignant cardiac tumor is seen most frequently in adults?

Sarcoma occurring most frequently in the right atrium. The most common morphologic subtypes include angiosarcoma, rhabdomyosarcoma, and fibrosarcoma. In general, these tumors are fatal, and the interval between diagnosis and death is very short. These sarcomas infiltrate the heart extensively so that resection is not possible, and they tend to extend locally into the pericardium, lung, and other surrounding structures. Eighty percent of these tumors have distant metastases at the time of discovery. Symptoms can range from nonspecific, such as anemia and weight loss, to frank congestive heart failure. On occasion, the first sign can be from a symptomatic metastasis.

Name the most common benign cardiac tumor seen in children.

Rhabdomyoma. These tumors arise from the ventricular surfaces and affect the right and left sides equally. They vary in size and cause symptoms either by obstructing intracardiac blood flow or by interfering with normal cardiac conduction. A high percentage (30%) of these tumors are associated with tuberous sclerosis, which ultimately determines their prognosis. They are congenital. Resection has been performed successfully.

Which tumor has the greatest propensity for cardiac metastases?

Malignant melanoma, with 50-65% of patients having cardiac metastases.

What four tumors are commonly associated with most cardiac metastases?

Leukemias

Bronchogenic carcinoma

Carcinoma of the breast

Lymphomas (Hodgkin’s and non-Hodgkin’s)

The tumors spread to the heart by direct extension from surrounding intrathoracic structures or by hematogenous or lymphatic spread. Direct extension is seen most often with bronchogenic carcinoma that has extended through the pericardium into the left atrium. Malignant pericardial effusions from noncardiac neoplasms can lead to the implantation of viable cells on the epicardial surface.

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