Difference between revisions of "Cardiac tumours"

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'''Cardiac tumours''' are rare buggers.
'''Cardiac tumours''' are rare buggers.


==Common heart tumours==
==Most common (malignant)==
*Metastases - most common cardiac tumour; 1:~100 primary tumours:secondary tumours.<ref name=pmid20472615>{{Cite journal  | last1 = Castillo | first1 = JG. | last2 = Silvay | first2 = G. | title = Characterization and management of cardiac tumors. | journal = Semin Cardiothorac Vasc Anesth | volume = 14 | issue = 1 | pages = 6-20 | month = Mar | year = 2010 | doi = 10.1177/1089253210362596 | PMID = 20472615 }}</ref>
 
==Primary heart tumours==
*Approximately 10% of resected (primary) cardiac tumours are malignant.<ref name=pmid18350921>{{cite journal |author=Burke A |title=Primary malignant cardiac tumors |journal=Semin Diagn Pathol |volume=25 |issue=1 |pages=39-46 |year=2008 |month=February |pmid=18350921 |doi= |url=}}</ref>
*Approximately 10% of resected (primary) cardiac tumours are malignant.<ref name=pmid18350921>{{cite journal |author=Burke A |title=Primary malignant cardiac tumors |journal=Semin Diagn Pathol |volume=25 |issue=1 |pages=39-46 |year=2008 |month=February |pmid=18350921 |doi= |url=}}</ref>
**90% are sarcomas.
**90% are sarcomas.
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Notes:
Notes:
*If one is considering only valves - ''papillary fibroelastoma'' is No. 1.
*If one is considering only valves - ''papillary fibroelastoma'' is No. 1.
Malignant heart tumours (in order of frequency):<ref name=pmid20472615>{{Cite journal  | last1 = Castillo | first1 = JG. | last2 = Silvay | first2 = G. | title = Characterization and management of cardiac tumors. | journal = Semin Cardiothorac Vasc Anesth | volume = 14 | issue = 1 | pages = 6-20 | month = Mar | year = 2010 | doi = 10.1177/1089253210362596 | PMID = 20472615 }}</ref>
#Undifferentiated.
#Angiosarcoma.
#Leiomyosarcoma.


==Myxoma==
==Myxoma==
===General===
===General===
*Rare.
*Uncommon.
*Clinical: may lead to cerebral infarction.<ref name=pmid3188128>{{cite journal |author=Knepper LE, Biller J, Adams HP, Bruno A |title=Neurologic manifestations of atrial myxoma. A 12-year experience and review |journal=Stroke |volume=19 |issue=11 |pages=1435-40 |year=1988 |month=November |pmid=3188128 |doi= |url=http://stroke.ahajournals.org/cgi/reprint/19/11/1435}}</ref>
*Clinical: may lead to cerebral infarction.<ref name=pmid3188128>{{cite journal |author=Knepper LE, Biller J, Adams HP, Bruno A |title=Neurologic manifestations of atrial myxoma. A 12-year experience and review |journal=Stroke |volume=19 |issue=11 |pages=1435-40 |year=1988 |month=November |pmid=3188128 |doi= |url=http://stroke.ahajournals.org/cgi/reprint/19/11/1435}}</ref>
*Diagnosed by imaging.
*Diagnosed by imaging.
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*Smooth surface.
*Smooth surface.


===Histology===
===Microscopic===
Features:<ref name=pmid12006696/>
Features:<ref name=pmid12006696/>
*Myxoid material - extra cellular (???) - '''key feature'''.
*Myxoid material - extra cellular (???) - '''key feature'''.
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*[http://commons.wikimedia.org/wiki/File:Atrial_myxoma_edge_high_mag.jpg Atrial myxoma - endothelial covering (wikimedia.org)].
*[http://commons.wikimedia.org/wiki/File:Atrial_myxoma_edge_high_mag.jpg Atrial myxoma - endothelial covering (wikimedia.org)].
*[http://commons.wikimedia.org/wiki/File:Atrial_myxoma_edge_low_mag.jpg Atrial myxoma - sharp border (wikimedia.org)].
*[http://commons.wikimedia.org/wiki/File:Atrial_myxoma_edge_low_mag.jpg Atrial myxoma - sharp border (wikimedia.org)].
==Rhabdomyoma==
*Very rare.
*Benign.
*Associated with [[tuberous sclerosis]].<ref name=pmid20721876>{{Cite journal  | last1 = Yinon | first1 = Y. | last2 = Chitayat | first2 = D. | last3 = Blaser | first3 = S. | last4 = Seed | first4 = M. | last5 = Amsalem | first5 = H. | last6 = Yoo | first6 = SJ. | last7 = Jaeggi | first7 = ET. | title = Fetal cardiac tumors: a single-center experience of 40 cases. | journal = Prenat Diagn | volume =  | issue =  | pages =  | month = Aug | year = 2010 | doi = 10.1002/pd.2590 | PMID = 20721876 }}</ref>
==Rhabdomyosarcoma==
See ''[[soft tissue tumours]]''.
==Lipoma==
*Like lipomas elsewhere in the body.
==Metastasis==
*Most common cardiac tumour; 1:~100 primary tumours:secondary tumours.<ref name=pmid20472615>{{Cite journal  | last1 = Castillo | first1 = JG. | last2 = Silvay | first2 = G. | title = Characterization and management of cardiac tumors. | journal = Semin Cardiothorac Vasc Anesth | volume = 14 | issue = 1 | pages = 6-20 | month = Mar | year = 2010 | doi = 10.1177/1089253210362596 | PMID = 20472615 }}</ref>
*Usually from lung. (???)
Malignant heart tumours:<ref name=pmid20472615>{{Cite journal  | last1 = Castillo | first1 = JG. | last2 = Silvay | first2 = G. | title = Characterization and management of cardiac tumors. | journal = Semin Cardiothorac Vasc Anesth | volume = 14 | issue = 1 | pages = 6-20 | month = Mar | year = 2010 | doi = 10.1177/1089253210362596 | PMID = 20472615 }}</ref>
#Undifferentiated.
#Angiosarcomas.
#Leiomyosarcomas.


==Fibroelastoma==
==Fibroelastoma==
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*[http://commons.wikimedia.org/wiki/File:Papillary_fibroelastoma.jpg Papillary fibroelastoma - low magnification (commons.wikimedia.org)].
*[http://commons.wikimedia.org/wiki/File:Papillary_fibroelastoma.jpg Papillary fibroelastoma - low magnification (commons.wikimedia.org)].
*[http://commons.wikimedia.org/wiki/File:Papillary_fibroelastoma2.jpg Papillary fibroelastoma - intermediate magnification (commons.wikimedia.org)].
*[http://commons.wikimedia.org/wiki/File:Papillary_fibroelastoma2.jpg Papillary fibroelastoma - intermediate magnification (commons.wikimedia.org)].
==Rhabdomyoma==
*Very rare.
*Benign.
*Associated with [[tuberous sclerosis]].<ref name=pmid20721876>{{Cite journal  | last1 = Yinon | first1 = Y. | last2 = Chitayat | first2 = D. | last3 = Blaser | first3 = S. | last4 = Seed | first4 = M. | last5 = Amsalem | first5 = H. | last6 = Yoo | first6 = SJ. | last7 = Jaeggi | first7 = ET. | title = Fetal cardiac tumors: a single-center experience of 40 cases. | journal = Prenat Diagn | volume =  | issue =  | pages =  | month = Aug | year = 2010 | doi = 10.1002/pd.2590 | PMID = 20721876 }}</ref>
==Rhabdomyosarcoma==
See ''[[soft tissue tumours]]''.
==Lipoma==
*Like lipomas elsewhere in the body.
DDx:
*Lipomatous hypertrophy.<ref name=pmid20196664>{{Cite journal  | last1 = Miller | first1 = DV. | last2 = Tazelaar | first2 = HD. | title = Cardiovascular pseudoneoplasms. | journal = Arch Pathol Lab Med | volume = 134 | issue = 3 | pages = 362-8 | month = Mar | year = 2010 | doi =  | PMID = 20196664 }}</ref>
==Cystic AV node tumour==
===General===
*Super rare.
*Usually 1-2 mm.
===Gross===
*"Bump" in the ''triangle of Koch''.
*Cystic spaces.
===Microscopic===
Features:
*Cystic spaces lined by epithelial cells.
*+/-Psammoma bodies. (???)
===IHC===
*CEA +ve.
*EMA +ve.


===Gross===
===Gross===
48,868

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