Cardiac tumors epidemiology and demographics


 * Associate Editor(s)-In-Chief: ; Varun Kumar, M.B.B.S.

Overview

 * Prevalence in autopsy series: 1/300 to 1/5900
 * 80% of primary tumors are benign:
 * 1/2 (40%) are myxomas
 * 1/2 (40% ) are of other types

Benign Tumors of the Heart
The most common primary tumor of the heart is the myxoma. In surgical series, the myxoma makes up as much as 77% of all primary tumors of the heart. Other benign tumors of the heart include rhabdomyomas, fibromas, hemangiomas, lipomas, paragangliomas, myocytic hamartomas, and papillary fibroelastomas.

Primary Malignant Tumors of the Heart
About 20 percent of primary tumors of the heart are malignant in nature. Malignant tumors of the heart include rhabdomyosarcomas, angiosarcomas, myxosarcomas, fibrosarcomas, leiomyosarcomas, reticulum cell sarcomas, and liposarcomas. The cardiac sarcomas may occur at any age, but are more commonly seen in individuals in their 20s to 40s. They occur equally in males and females.

A subset of the primary tumors of the heart are tumors that are found on the valves of the heart. Tumors that affect the valves of the heart are found in an equal distribution among the four heart valves. The vast majority of these are papillary fibroelastomas. Primary tumors of the valves of the heart are more likely to occur in males. While most primary tumors of the valves of the heart are not malignant, they are more likely to have symptoms related to the valve, including neurologic symptoms and (in a few cases) sudden cardiac death.

Secondary (metastatic) Malignant Tumors of the Heart

 * 20 to 40x more common than primary cardiac tumors
 * Typically carcinomas, melanomas, and leukemias/lymphomas
 * Discrete tumors found in 10 to 12% of all autopsies
 * Any involvement of heart by a malignancy found in 20% of all autopsies

Pericardium
 * Frequently bloody effusion containing tumor cells
 * Tamponade
 * May also cause constriction from tumor infiltration of pericardial sac