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Primary cardiac tumors: surgical experience and follow-up
Vijay Agarwal1, Surendra Kumar Agarwal, Ashok Kumar Srivastava
1Department of Cardiovascular and Thoracic Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow.
Insights
Primary cardiac tumors are rare, with surgery offering excellent outcomes for benign types. Malignant tumors, though surgically debulked for symptom relief, had a poor prognosis with recurrence and metastasis observed in this study of 34 patients.
Area of Science:
- Cardiovascular Surgery
- Oncology
- Cardiac Pathology
Background:
- Primary cardiac tumors are infrequent, with limited case reports originating from India.
- This study details surgical experiences with primary cardiac tumors over a 12-year period.
Purpose of the Study:
- To review the surgical outcomes and long-term follow-up of patients with primary cardiac tumors.
- To analyze the characteristics and treatment efficacy for both benign and malignant cardiac neoplasms.
Main Methods:
- Retrospective analysis of 34 patients with primary cardiac tumors operated between December 1989 and October 2001.
- Diagnosis confirmed via echocardiography for benign tumors; malignant tumors identified intraoperatively.
- Surgical intervention focused on complete resection for benign tumors and debulking for malignant tumors.
Main Results:
- The study included 16 males and 18 females (mean age 40.05 years). Predominant symptoms were dyspnea and heart failure.
- Myxoma (31 cases) was the most common benign tumor; fibroma (1) and leiomyosarcoma (2) were also identified.
- All patients survived surgery. Benign tumors showed no recurrence post-surgery. Malignant tumors recurred, leading to distant metastases and patient demise.
Conclusions:
- Surgical intervention yields excellent long-term results for benign primary cardiac tumors.
- While surgery provides symptomatic improvement for malignant cardiac tumors, the overall prognosis remains poor due to high recurrence and metastasis rates.
Background:
Primary cardiac tumors are rare. There are only a few reports of such tumors from India.
Methods And Results:
We report our experience with 34 patients with primary cardiac tumors operated on at our institute between December 1989 and October 2001. The study group comprised 16 males and 18 females with a mean age of 40.05 +/- 13.06 years (range 7-65 years). The predominant symptoms were breathlessness and congestive heart failure. In addition, 1 patient presented with peripheral embolism with impending limb ischemia that necessitated emergency embolectomy. Echocardiography was confirmatory in the diagnosis of all the benign tumors, whereas the malignant tumors were incidentally found during surgery. All the patients survived the operation. Complete resection of the tumor was possible only in benign tumors; however, malignant tumors were partly removed to relieve obstruction. All the excised benign tumors showed no recurrence on a mean follow-up of 54.78 +/- 31.30 months (range 3-108 months). Myxoma was found in 31 patients, left ventricular fibroma in 1, and leiomyosarcoma in 2. Both the patients with malignant tumors developed recurrence postoperatively, and succumbed to extensive distant metastases.
Conclusions:
The long-term outcome of surgery was excellent in patients with benign cardiac tumors. However, malignant tumors had an unchanged prognosis, although symptomatic relief was achieved.