Differential diagnosis of cardiac tumors: General consideration and echocardiographic approach

Abstract

Cardiac tumors may be primary (either benign or malignant) or secondary (malignant) and are first detected by echocardiography in most cases. The cardiologist often challenges their identification, the differential diagnosis and the best therapeutic approach. Malignant tumors have usually a poor prognosis, which may be significantly improved by appropriate and timely therapies. The echocardiographic aspects of benign and malignant cardiac tumors described in this article, along with a clinical evaluation may orient the differential diagnosis and aid in choosing the further steps useful to define the nature of the mass,

Cardiac Metastatic Tumors

“…The team involved in diagnostics and treatment should be multidisciplinary, including oncologists, cardiologists, radiologists, nuclear medicine doctors, cardio-oncologists, if it is possible. 18 Echocardiography is the most common method when diagnosing cardiac tumors and should be taken under consideration as an initial method. 4,18,20 It includes techniques such as 3D echocardiography, transthoracic echocardiography, transesophageal echocardiography (TEE), or use of ultrasonic enhancing agents.…”

“…18 Echocardiography is the most common method when diagnosing cardiac tumors and should be taken under consideration as an initial method. 4,18,20 It includes techniques such as 3D echocardiography, transthoracic echocardiography, transesophageal echocardiography (TEE), or use of ultrasonic enhancing agents. Echocardiography allows examining the heart's size, its morphology, and hemodynamic parameters, such as intracardiac flow using the Doppler method.…”

“…4 Differential diagnosis should include the thrombus, vegetation, infections, pericardial cysts, lypomatous hypertrophy, or cardiotoxicity of chemotherapy in patients with primary tumor. 5,9,18…”

“…1 It is worth noting that tumors may be present in every cavity or in every wall of the heart. 18 Lung cancer metastases tend to locate in the left atrium, whereas ovarian or liver cancer metastasesare locatedin the right atrium or ventricle. Connection with pulmonary veins or with inferior vena cava may suggest a metastatic character of the mass.…”

“…Metastases may also appear as intramural or intrapericardial. 18 Pericardial metastases are the most common. 16 In some cases, cardiac tumor symptoms can appear as nonspecific, which may affect the delay of correct diagnosis.…”