Manangement High propensity for embolization Surgical results excellent
Benign Primary Cardiac Tumors Familial pattern of Myxomas with autosomal dominant features Age < 30 Carney Complex
Papillary Fibroelastoma The most common valvular tumor, followed by • Sarcoma • Melanoma Present in all age groups, but most commonly in Age>60
Papillary Fibroelastoma Small tumors (<1cm) with homogeneous speckeled pattern Commonly pedunculated with multiple fronds Affect the Lt and Rt sides with same frequency Attach to • Atrial surface of AV valves, and • Ventricular surface of semilunar valves
Papillary Fibroelastoma Adults Aortic valve Children Tricuspid valve Rarely on endocardial surfaces Symptomatic only in the aortic position (other than embolic Sx) • Ostial occlusion angina, sudden death • Rarely valvular dysfunction Source of embolization in up to 30% of patients
Fibromas Encapsulated, solitary tumors Frequently in the septal myocardium Often encroach on the conduction system as they grow
Fibromas With septal involvement V.Fib is often the first presentation Indications for surgical resection: • Mechanical problems due to size • Arrhythmogenic nidus Resection of septal fibromas is not always possible
LipomasAffect both myocardium and pericardium Can reach several centimeters in size
Rhabdomyoma: Most common tumor of the heart for Age < 30 yr Almost exclusively in children Associated with tuberous sclerosis Regression of tumor in infancy has been reported
A large firm, white tumor mass wasfound filling the left ventricle. This is a cardiac rhabdomyoma.
Angiosarcomas Most common primary malignancy of the heart Malignant cells that form vascular channels Most commonly affect the • Rt. Heart Rt. Atrium • Pericardium Hemorrhagic effusion Thrombus
Angiosarcomas Diffuse, irregularly shaped Mean survival one year Successful Rx with Chemo and XRT followed by transplant reported
Rhabdomyosarcomas Most commonly seen in adults No chamber selectivity No pericardial involvement Multiple sites of cardiac involvement is common Poor prognosis Limited success with resection and adjuvant Rx.
Mesotheliomas Diffuse pericardial tumor Involve both parietal and visceral pericardium Superficially invade the myocardium Rarely invade the cardiac chambers
Mesotheliomas Sx of pericarditis or tamponade Poor prognosis XTR or chemo only offer temporary improvement