Cardiac tumors (heart tumors) are abnormal growths in the heart ranging from <1 cm to 15 cm. Primary tumors are rare (0.001%-0.3% autopsy); metastatic tumors are more frequent (2.3%-18.3%).
Benign Primary Heart Tumors
75% to 95% of primary heart tumors are benign:
• Adults: Myxoma (~50% of cases, left atrium, embolic risk), Papillary fibroelastoma (aortic/mitral valves, age >60), Lipoma, Hemangioma.
• Children: Cardiac rhabdomyoma (clusters, often regresses), Teratoma, Fibroma, and Purkinje cell hamartoma.
Malignant & Metastatic Heart Tumors
5-25% of primary heart tumors are malignant (Sarcomas: Angiosarcoma right atrium, Rhabdomyosarcoma, MFH, Lymphoma).
Metastatic heart tumors spread from melanoma, lung, breast, kidney, or esophageal cancers.
Symptoms & 'Tumor Plop' Sign
Diagnostic Sign: Distinctive 'tumor plop' sound heard during stethoscope auscultation as pedunculated tumor blocks mitral valve during diastole.
Clinical signs: Heart failure dyspnea/edema, weight loss, fatigue, hemoptysis, arrhythmias, chest pain, embolic stroke-like symptoms, and pericardial effusion.
Surgical Resection & Care
Diagnostics: Echocardiography (TTE/TEE), Chest X-ray, Endomyocardial Biopsy, Cardiac MRI, PET scan.
Surgery: Simple tumor removal (myxomas), Complex tumor removal (Fontan circulation), Ex-situ tumor removal (temporary heart removal for excision before reimplantation), Total Artificial Heart (TAH), or Heart transplantation.