Surgical Treatment of Primary Cardiac Sarcomas: Review of a Single-Institution Experience

Abstract

Primary cardiac sarcoma is a rare but lethal disease. Surgical intervention is associated with acceptable surgical mortality in this high-risk group of patients.

Pathology, imaging, and treatment of cardiac tumours

“…Malignant primary cardiac tumours can present with the same nonspecific character istics as benign primary cardiac tumours, or with manifestations of systemic metastases. A study involving 34 patients with primary malignant cardiac tumours observed over a 32-year period reported symptoms such as dyspnoea on exertion (79%), chest pain (38%), cough (21%), paroxysmal nocturnal dyspnoea (12%), haemopty sis (12%), embolic events (9%), fever (9%), syncope (6%), and orthopnoea (6%) 54,55 .…”

Cardiac sarcoma presenting with abdominal pain and mimicking myxoma on echocardiogram

“…There is no gender preference noted, and presentation is usually in the fourth decade of life. 3 Three large series (reviewing 34, 21 and 95 cases respectively) showed that overall median survival was 12–20 months. 3–5 Moreover, they also showed that survival was 6–10 months in R1 resection while that improved to 12–24 months in R0 resection.…”

“…Unsurprisingly, case series have shown that R0 resection can be achieved in only 38–42% of cases. 3–5 Furthermore, emergency surgery was performed for palliation or to prevent further embolism that can lead to partial tumour resection. Thus, local recurrence is certain.…”

Commentary: Primary cardiac sarcoma—Systemic disease requires systemic therapy

“…Our last publication of our overall primary cardiac sarcoma experience had 95 cases of surgical resection. 2 A current query of our database shows that the number has now risen to 206 surgical cases. This experience has led us to believe that primary cardiac sarcoma, especially cardiac angiosarcoma, should be considered a systemic disease when first seen.…”