Cardiac tumours

Cardiac tumours are rare buggers. They provide some work for cardiac surgeons.

Most common malignant

• Metastases - most common cardiac tumour; 1:~100 primary tumours:secondary tumours.

Primary heart tumours

• Approximately 10% of resected (primary) cardiac tumours are malignant.
  • 90% are sarcomas.
  • 10% are lymphomas.

In order of frequency:

1. Myxoma.
2. Lipoma.
3. Papillary fibroelastoma.

Notes:

• If one is considering only valves - papillary fibroelastoma is No. 1.

Malignant heart tumours (in order of frequency):

1. Undifferentiated.
2. Angiosarcoma.
3. Leiomyosarcoma.

Note:

• According to WMSP: Most common primary malignant tumour of the heart = angiosarcoma.

Specific entities

Cardiac myxoma

Main article: Cardiac myxoma

This includes the common atrial myxoma.

Papillary fibroelastoma

• AKA fibroelastoma.
• AKA giant Lambl excrescence.

General

• Usually an incidental finding.

Gross

• Friable appearing.
• Yellow.
• Typically on free edge.

Image:

• Papillary fibroelastoma (e-heart.org).

Microscopic

Features:

• Braching papillary fronds which are:
  • Composed of collagen, and
  • Avascular.
• +/-Elastic tissue.
• Surrounded by:
  • Endothelium, and
  • Mucopolysaccharide.

Images

• 

  Papillary fibroelastoma - low mag. (WC)

• 

  Papillary fibroelastoma - intermed. mag. (WC)

Cardiac rhabdomyoma

Main article: Rhabdomyoma

• Very rare.
• Benign.
• Associated with tuberous sclerosis.

Rhabdomyosarcoma

See rhabdomyosarcoma.

Lipoma

Main article: Adipocytic tumours

• Like lipomas elsewhere in the body.
• Usually location: left ventricle, subendocardial.

DDx:

• Lipomatous hypertrophy.

Cystic tumour of the atrioventricular nodal region

Main article: Cystic tumour of the atrioventricular nodal region

See also

• Heart.
• Valvular heart disease.