Primary cardiac tumours: a single-center 41-year experience

Abstract

Primary cardiac tumours are extremely rare with the most commonest being left atrial myxomas. In general, surgical resection is indicated, whenever the tumour formation is mobile and embolization can be suspected. Within 17280 patients receiving heart surgery at the Innsbruck Medical University, 78 patients (0.45%) underwent tumourectomy of primary cardiac tumours. The majority of patients (63) suffered from a left or right atrial myxoma, 12 showed a papillary fibroelastoma of the valves at echocardiographical or histological examination, 1 suffered from a hemangioma, 1 from a chemodectoma, and another one from a rhabdomyosarcoma. The mean age of cardiac tumour patients was 54.29 ± 13.28 years (ranging from 18 to 83 years). 67.95% of the patients were female and 32.05% were male. The majority of tumours were found incidentally; 97.44% of the patients showed no tumour recurrence.

Figure 1

(a) and (b) Papillary fibroelastoma of the aortic valve with papillary configuration with an avascular connective tissue core lined by a single layer of endothelial cells (H&E: on the left side, original magnification ×100; on the right side, original magnification ×400).

Figure 2

(a) Left atrial myxoma consisting of a mucoid stroma with spindle-shaped cells, with hemorrhage in the centrum of the myxoma (H&E staining, original magnification ×100); (b) High power view (H&E staining, original magnification ×400).

Figure 3

(a) CAB (Chromotrope Aniline blue) staining of myxoma tissue colouring fibrous tissue blue and vascularized areas red (CAB staining, original magnification ×100). (b) Iron stain of macrophages colouring iron yellowish (Iron stain, original magnification ×600).

Figure 4

(a) Rhabdomyosarcoma surrounded by a fibrous capsule and myocardial tissue (H&E staining, original magnification ×100); (b) high power image of rhabdomyosarcoma cells (H&E staining, original magnification ×400).

Figure 5

(a) and (b) Capillary hemangioma with proteoglycan-rich stroma within the fibrous capsule (H&E staining, original magnification ×100).

Figure 6

(a) Nests of paraganglioma cells surrounded by a fibrous capsule and adjacent myocardial tissue consisting of myocytes with enlarged nuclei (H&E staining, original magnification ×100); (b) H&E staining, original magnification ×400.