Primary Cardiac and Pericardial Neoplasms: Radiologic-Pathologic Correlation

Abstract

Primary cardiac and pericardial neoplasms are rare lesions and include both benign and malignant histologic types. Myxoma is the most frequent primary cardiac neoplasm, but other benign tumors include papillary fibroelastoma, rhabdomyoma, fibroma, hemangioma, lipoma, and paraganglioma. Cardiac sarcoma represents the second most common primary cardiac neoplasm. Lymphoma can also affect the heart primarily. Pericardial tumors that affect the heart include benign teratomas and malignant mesotheliomas. Patients affected with cardiac or pericardial neoplasms often present with cardiovascular compromise or embolic phenomena and exhibit cardiomegaly at chest radiography. Benign cardiac tumors typically manifest as intracavitary, mural, or epicardial focal masses, whereas malignant tumors demonstrate invasive features and may involve the heart diffusely. Benign lesions can usually be successfully excised, but patients with malignant lesions have an extremely poor prognosis.

Resection of a cardiac hemangioma in a patient with chest pain

“…Cardiac hemangiomas have a non-specific pattern on unenhanced CT but in most cases, they show intense enhancement with contrast [6] . Cardiac MRI provides a more specific image and may provide a qualitative diagnosis [7] .…”

Multimodal Cardiovascular Imaging of Cardiac Tumors

“…Myxomas can be spherical or ovoid shaped; have smooth margins; consist of various components, such as myxoid and fibrous tissue and calcifications; and can exhibit hemorrhaging. Myxomas display low to iso-density on non-contrast-enhanced CT (14,18). Calcification is more common in right atrial masses and is clearly shown on CT. On MRI, myxomas typically display low intensity on T1WI and high intensity on T2WI; however, they sometimes exhibit heterogeneous signal intensity due to mucoid degeneration or hemorrhaging (21).…”

A Rare Case with Primary Undifferentiated Carcinoma of Pericardium

“…1)2) Because of their rarity, it is very difficult to generalize about the initial clinical presentation and the clinical courses of the specific neoplasms. These tumors demonstrate aggressive behavior and extremely poor prognosis.…”

“…Primary cardiac tumors are rare, with an incidence of 0.02%. 1) Majority of these tumors are benign, with myxoma comprising 50% of primary cardiac tumors. Malignant tumors account for 25% of primary cardiac tumors.…”