Characterization and Management of Cardiac Tumors

Abstract

Cardiac tumors are infrequent clinical entities with an autopsy frequency ranging from 0.001% to 0.030%. The occurrence of metastatic cardiac tumors has been reported a 100-fold more commonly than primary lesions. Three quarters of primary cardiac tumors are benign; approximately half of these are cardiac myxomas, and the rest are lipomas, papillary fibroelastomas, and rhabdomyomas. Among malignant primary cardiac tumors, the most reported are those histopathologically considered as undifferentiated, followed by angiosarcomas and leiomyosarcomas. Traditionally, cardiac tumors have been identified as curious autopsy findings resulting in a literature paucity of large clinical series, therefore, providing knowledge mostly based on case report collection. However, recent technological advances in noninvasive imaging modalities such as echocardiography and cardiac magnetic resonance imaging (MRI) have resulted in a rapid acquisition of real-time heart images with high spatial and temporal resolution and an excellent tissue characterization of the tumor. This consequent earlier, more frequent, and more complete assessment of cardiac tumors before significant symptoms develop has challenged cardiologists, cardiac anesthesiologists, and surgeons to create a tailored referral pattern and approach.

Cardiac myxomas and their surgical results

“…[2,4,7,10,14] Ancak EKO miksoma gibi primer kardiyak tümör ve diğer kardiyak kitle ayırımda spesifik değildir. Kardiyak miksoma en sık atriyal trombüs ile karışır.…”

“…Tümör eksizyonu sonrası hastalarda blok, atriyal fibrilasyon, supraventriküler taşikardi ve junctional ritim gelişebilir. [4,9,14] Bizim çalışmamızda da ameliyat sonrası iki hastada amiodaron infüzyonu ile sinüs ritmine dönen atriyal fibrilasyon ve bir hastada junctional ritim gelişti.…”

“…Primer kardiyak tümörlerin yaklaşık %80'i iyi huyludur ve bunların yarısından fazlası miksomalardır. [2][3][4][5] Tüm yaş gruplarında izlenmekle birlikte özellikle yaşamın 3. ve 6. dekatlarında sık görülürler. [2,4,5] Miksomalar genellikle sporadik olmakla birlikte ailesel geçişli olanları da vardır.…”

Pericardial Masses, Cysts and Diverticula: A Comprehensive Review Using Multimodality Imaging

“…12 When patients do present with symptoms they may be non-specific including chest pain, dyspnea, palpitations, syncope or systemic symptoms and often mimic other conditions of the pericardium such as pericarditis, pericardial effusion, constriction or tamponade. 13 Physical examination findings may include a pericardial rub or knock, muffled heart sounds, elevated jugular venous distention, hepatomegaly, edema or pulsus paradoxus. 14 Imaging findings vary in specificity depending on the type of tumor, but the most common findings are pericardial thickening or effusion.…”

Cardiac Myxoma: Fourteen-Year Experience of a Tertiary Reference Center

“…Primer kardiyak tümörlerin ise yaklaşık olarak %80'i iyi huyludur ve miksomalar en sık gö-rülen iyi huylu primer kardiyak tümörlerdir (3) . Tüm yaş gruplarında görülebilmekle birlikte en sık 30 ila 60 yaş aralığında saptanırlar (4) . Sporadik miksomalar kadınlarda erkeklere göre 2-4 kat daha sık görülürler.…”