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Primary benign
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Myxoma: most common type of primary cardiac tumor, 30-60-year-old women, interatrial septum of the left atrium, polypoid and round, surgery is the first line treatment |
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Rhabdomyoma: most common cardiac tumor in children, involving the myocardium of both ventricles and interventricular septum, may regress spontaneously, surgical treatment |
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Papillary fibroelastoma: small, round pedunculated valvular mass with multiple projections, most commonly in aortic valve, risk for embolic events, surgical treatment |
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Fibroma: commonly affecting infants and children, solitary mass, free wall of the left ventricle and ventricular septum, surgical treatment, present in Gorlin-Goltz syndrome |
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Lipoma: derived from mature adipocytes enclosed by a collagenous capsule, frequently involving the endocardium of right atrium, left ventricle and pericardium, surgical treatment |
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Hemangioma: proliferation of endothelial cells, leading to an increase in vascularization, most common location in right atrium, surgery usually is the first choice of treatment |
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Primary malignant
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Angiosarcoma: the most common and has the worst prognosis, mostly diagnosed in middle-aged men, predilection for right atrium, surgical treatment is preferred |
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Rhabdomyosarcoma: second most common, arising from undifferentiated skeletal tissue, frequently infiltrates pericardium and heart valves, multimodality treatment |
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Leiomyosarcoma: soft tissue sarcoma, different smooth muscle features, most common in left atrium, may look like a myxoma in imaging studies, surgical treatment |
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Undifferentiated pleomorphic sarcoma: high-grade sarcoma with a high variable morphology, nuclear pleomorphism with spindle shaped cells |
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Osteosarcoma: extremely rare, most observed in left atrium, subtypes may be present osteoblastic, chondroblastic, and fibroblastic) |
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Synovial sarcoma: most common in men and involves pericardium and right ventricular outflow tract, grossly large and covered with fibrous pseudocapsules |
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Fibrosarcoma: mesenchymal origin, surgical treatment including transplantation, TRK inhibitors in infantile fibrosarcomas |
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Lymphoma: non-Hodgkin lymphoma, most common in right atrium, CHOP or CHOP + rituximab chemotherapy regimen |
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Secondary or metastatic
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Frequent sites of primary cancers that metastasize to the heart include lung, pleural mesothelioma, skin melanoma, breast, esophagus, and hematologic malignancies. The most frequent location is the pericardium, accounting for two-thirds of cases. Surgical resection for selected cases, including the use of cardiopulmonary bypass |
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