Tumors of the Heart Experiences at the Giessen University Clinic

Abstract

Of 54 cardiac tumors operated upon in our clinic, 42 were classified as benign and only 12 as malignant. The major part of the benign tumors were myxoma, mainly located in the left atrium. While smaller tumors could be treated by local resections, extensive resections were necessary in 14 patients with greater tumors followed by reconstructions of the pulmonary and caval vein, mitral and tricuspid valve, and major parts of the right and left ventricular wall. In one patient with a huge benign myxoma, tumor exposition and total resection could only be achieved by an autotransplantation of the heart. While mortality after surgical therapy of benign tumors was only 1.4% (1/42) within a mean follow-up time of 48 months, the prognosis of malignant tumors is still fatal with a mortality of 50% (6/12) within a mean follow-up time of 24 months, despite additional chemotherapy or radiation.

Surgical Treatment of Primary Cardiac Tumors

“…Although Carney Complex has a high risk of recurrence, neither father nor son has had any recurrence of myxoma over observation periods of 15 years and 2 years, respectively. The prognosis for benign non-myxomas is generally favorable with a low recurrence, 3,[6][7][8][9][10][11][12][13][14][15][16] and no recurrent tumors were observed in the present series. Moreover, the prognosis of patients was quite good even if they underwent incomplete resection.…”

“…To clarify the current clinical characteristics of primary cardiac tumors, other series on surgery for primary cardiac tumors were researched in the English literature. 3,[6][7][8][9][10][11][12][13][14][15][16] For this purpose, we researched studies on cardiac myxomas only; other specific tumors, pericardial tumors or metastatic cardiac tumors were excluded.…”

“…Non-myxoma cardiac tumors arise at various locations and it is difficult to establish a regular surgical strategy. 3,[6][7][8][9][10][11][12][13][14][15][16] Various cardiotomy procedures are possible and complete excision of all visual tumors with a cuff of normal tissue is required. However, in cases of malignant cardiac tumors, this is often difficult because of invasion or tumor extension.…”

“…13 In contrast, the prognosis of patients with primary malignant cardiac tumors is very poor. 3,[6][7][8][9][10][11][12][13][14][15][16] In the present series, all patients with malignant tumors died within 14 months. Similar results were observed in other series and, of 135 patients with malignant cardiac tumors, only 3 patients were still alive 3 years after surgery.…”

“…Similar results were observed in other series and, of 135 patients with malignant cardiac tumors, only 3 patients were still alive 3 years after surgery. 3,8,12 In comparison with malignant tumors from other organs, the prognosis of malignant cardiac tumors is very poor. 25 Therapy for malignant cardiac tumors usually consists of surgical resection, advanced chemotherapy and irradiation.…”