Cardiac Cancer

Excerpt

Cardiac tumors are uncommon and can be primary or metastatic. Primary cardiac tumors are rare, with an incidence ranging from 0.001% to 0.3% by autopsy. On the other hand, metastatic cardiac tumors were found in 2.3% and 18.3% of autopsies. In addition to autopsy findings, contemporary imaging modalities, including echocardiography, cardiac magnetic resonance imaging (MRI), and computed tomography (CT), have significantly enhanced cardiac tumors' detection and anatomical delineation, many of which historically remained unrecognized until postmortem examination.

The World Health Organization categorizes primary cardiac neoplasms into 4 principal groups: benign tumors, neoplasms of indeterminate biological potential, germ cell tumors, and malignant variants. Sometimes, the pericardial tumors are also included in the classification of cardiac tumors. This classification was proposed in 2015, then updated in 2021, without substantial change.

Nearly 75% to 90% of primary cardiac tumors are benign. Benign tumors include rhabdomyoma, cardiac myxoma, fibroma, lipoma, and papillary fibroelastoma, among others. Myxoma is the most common primary tumor of the heart, accounting for slightly more than half of all primary cardiac tumors. Neoplasms of uncertain behavior encompass inflammatory myofibroblastic tumors and paragangliomas. Germ cell tumors, both cardiac and pericardial, comprise mature and immature teratomas and yolk sac tumors.

Malignant cardiac tumors are primarily sarcomas, eg, angiosarcoma, rhabdomyosarcoma, and undifferentiated pleomorphic sarcoma, along with primary cardiac lymphomas. The pericardial compartment may host similar malignant entities, including angiosarcoma, synovial sarcoma, malignant mesothelioma, and germ cell tumors.Malignant cardiac tumors are rare and account for 10% to 25% of all primary cardiac neoplasms. Tumors that metastasize to the heart are much more common than primary cardiac tumors, forming approximately 95% of all cardiac tumors, but are rarely surgically excised.