Oncologic essentials in malignant cardiac masses (approach and follow-up)





Key points





  • Malignant tumors are extremely rare.



  • 25% of primary cardiac tumors are malignant.



  • Most malignant cardiac tumors are metastatic (from breast, lung, melanoma, soft tissue sarcoma, etc.).



  • Sarcoma, lymphoma, and malignant pericardial mesothelioma are three main primary malignant cardiac tumors.



  • Usual imaging studies consist of TTE, CMR, and contrast TTE that are helpful noninvasive tools to diagnose suspicious cardiac masses.



  • 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

Major outlines of the 2015 WHO classification of tumors of the heart and pericardium .













Benign tumors and tumor-like conditions
Tumors of uncertain biologic behavior
Germ cell tumors
Malignant tumors
Tumors of the pericardium


Table 23.2

Incidence of different subtypes of primary malignant cardiac tumors .





































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

Incidence of cardiac metastasis in several malignancies .











































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%

Fig. 23.4


Outlines of malignant cardiac tumors.



Nov 10, 2024 | Posted by in CARDIOLOGY | Comments Off on Oncologic essentials in malignant cardiac masses (approach and follow-up)

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