Key points
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Malignant tumors are extremely rare.
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25% of primary cardiac tumors are malignant.
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Most malignant cardiac tumors are metastatic (from breast, lung, melanoma, soft tissue sarcoma, etc.).
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Sarcoma, lymphoma, and malignant pericardial mesothelioma are three main primary malignant cardiac tumors.
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Usual imaging studies consist of TTE, CMR, and contrast TTE that are helpful noninvasive tools to diagnose suspicious cardiac masses.
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Generally, despite multimodal treatment strategies, prognosis of malignant cardiac tumors is poor.
Epidemiology and classification
Malignant cardiac tumors are extremely rare (0.001%–0.03% in most autopsy series) and account for 10%–25% of primary cardiac masses .
Table 23.1
Benign tumors and tumor-like conditions |
Tumors of uncertain biologic behavior |
Germ cell tumors |
Malignant tumors |
Tumors of the pericardium |
Table 23.2
Primary cardiac tumors | Incidence |
---|---|
Benign | 70%–75% |
Malignant | 25%–30% |
Angiosarcoma | 9% |
Rhabdomyosarcoma | 6% |
Mesothelioma | 4% |
Fibrosarcoma | 3% |
Lymphoma | 2% |
Other sarcomas | 3% |
Teratoma | < 1% |
Other | < 1% |
Table 23.3
Secondary cardiac tumors | Rate of heart metastasis % |
---|---|
Pleural mesothelioma | 48.4% |
Melanoma | 27.8% |
Lung adenocarcinoma | 21% |
Undifferentiated carcinoma | 19.5% |
Lung squamous cell carcinoma | 18.2% |
Breast carcinoma | 15.5% |
Ovarian carcinoma | 10.3% |
Lymphoproliferative neoplasms | 9.4% |
Bronchoalveolar carcinoma | 9.8% |
Gastric carcinoma | 8% |
Renal cell carcinoma | 7.3% |
Pancreatic carcinoma | 6.4% |