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. 2017 Nov 28;12(1):103.
doi: 10.1186/s13019-017-0672-7.

Primary and metastatic cardiac tumors: echocardiographic diagnosis, treatment and prognosis in a 15-years single center study

Natsumi Nomoto  1 , Tomoko Tani  2 , Toshiko Konda  1 , Kitae Kim  3 , Takeshi Kitai  3 , Mitsuhiko Ota  3 , Shuichiro Kaji  3 , Yukihiro Imai  4 , Yukikatsu Okada  5 , Yutaka Furukawa  3
Affiliations

Primary and metastatic cardiac tumors: echocardiographic diagnosis, treatment and prognosis in a 15-years single center study

Natsumi Nomoto et al. J Cardiothorac Surg. .

Abstract

Background: The frequency of primary cardiac tumors is rare at about 0.3% by autopsy. Our objective was to investigate the characteristics and locations of cardiac tumors and to provide a prognostic analysis in our hospital.

Methods: We collected data on 95 patients with echocardiographic diagnosis or detection of cardiac tumors in a prospective analysis from 1999 to 2014. The median follow-up period was 43 months (0.5-183 months).

Results: The subjects included 56 men and 39 women with a mean age of 65 years. Clinical diagnosis revealed primary tumors in 61 patients (64%) and secondary metastatic tumors in 34 patients (36%). In the 61 patients, 41 patients (67%) underwent surgery and tissue samples were obtained. Of these 41 patients, benign tumors were found in 30 cases (73%). One patient (2%) was diagnosed with thrombus. Among the benign tumors, myxoma (67%) was the most common type followed by papillary fibroelastoma (23%). The most common site was the left atrium (35%) followed by the right atrium (25%). Primary malignant tumors were diagnosed in 10 cases (24%), including 6 angiosarcomas, 3 lymphomas, and 1 leiomyosarcoma. The diagnostic accuracy of echocardiography was 80%. The patients with benign tumors were all alive at the end of the follow-up period. In contrast, 7 patients with malignant tumors died (70%) (p < 0.0001).

Conclusions: Our data is in line with previous literature. Our study also suggests the necessity of extending our knowledge of the characteristics of cardiac tumors for diagnosis.

Keywords: Cardiac tumor; Diagnosis; Echocardiography; Prognosis.

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Conflict of interest statement

Ethics approval and consent to participate

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation of Kobe City Medical Center General Hospital and with the Helsinki Declaration of 1964 and later revisions. Informed consent was obtained from all patients for being included in the study.

Consent for publication

Not consent for publication to disclose.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Description of the patient population
Fig. 2
Fig. 2
Distribution of cardiac tumors diagnosed and treated at our hospital. We excluded one case that was diagnosed as thrombus by pathological data
Fig. 3
Fig. 3
Representative cases incorrectly diagnosed by transthoracic echocardiography. a. Horizontal section of a right parasternal view. Thrombus attached to RA appendage (arrow). We misdiagnosedthis as an RA myxoma. b. Left parasternal four-chamber view. We could not diagnose the tumor type before surgery. A leiomyosarcoma arose from the coronary sinus and was detected around the LV (arrows). RA = right atrium, LA = left atrium, IVC = inferior vena cava, SVC = superior vena cava, LV = left ventricle, RV = right ventricle
Fig. 4
Fig. 4
Demographics of origins of metastatic cardiac tumors
Fig. 5
Fig. 5
Kaplan–Meier survival curves of patients undergoing surgery for cardiac tumors. Overall survival of the patients with benign and malignant cardiac tumors
See this image and copyright information in PMC

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