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[Heart tumors: incidence, distribution, diagnosis. Exemplified by 20,305 echocardiographies]
G Sütsch1, R Jenni, L von Segesser
1Departement für Innere Medizin, Universitätsspital Zürich.
Insights
Doppler-echocardiography detected cardiac tumors in 0.15% of patients. Atrial myxomas were the most common benign cardiac tumors, while secondary tumors often appeared in the right atrium. Careful imaging is crucial for diagnosis.
Area of Science:
- Cardiology
- Oncology
- Diagnostic Imaging
Background:
- Cardiac tumors are rare, with varying origins and presentations.
- Doppler-echocardiography is a key non-invasive tool for cardiac mass detection.
Purpose of the Study:
- To review the occurrence, types, and locations of cardiac tumors identified via Doppler-echocardiography.
- To analyze the characteristics of primary and secondary cardiac tumors.
Main Methods:
- Retrospective analysis of 20,305 consecutive Doppler-echocardiography studies over four years.
- Classification of identified cardiac tumors into primary, secondary, or unclassified categories.
- Detailed examination of tumor histology, location, and patient demographics.
Main Results:
- Cardiac tumors were found in 30 patients (0.15%), with a mean age of 53.
- Primary tumors (70%) were mostly benign myxomas (86%), predominantly in the left atrium (89%).
- Secondary tumors (17%) were metastatic, often located in the right atrium (80%).
Conclusions:
- Atrial myxomas are the most frequent cardiac tumors, typically found in the left atrium.
- Thorough echocardiographic assessment of all cardiac chambers and vessels is essential for accurate tumor detection and characterization.
- Early and precise diagnosis aids in managing cardiac tumors and detecting recurrence.
Abstract:
The occurrence, type and location of cardiac tumors as detected by Doppler-echocardiography are reviewed. In a series of 20,305 consecutive echocardiographic studies performed at our institution over a four-year period, cardiac tumors were identified in 30 patients (0.15%; 17 male and 13 female, mean age 53 years). Primary cardiac tumors were detected in 21/30 patients (70%; mean age 50 years), secondary tumors in 5/30 patients (17%; mean age 58 years); however, in 4/30 patients (13%) the tumors could not be classified (mean age 59 years). In the group with primary tumors, benign cardiac tumors were found in 18/21 patients (86%) and malignant tumors in 3/21 (14%). All benign cardiac masses were myxomas (18/18) and accounted for 60% of all tumors; they were mainly located in the left atrium (16/18 or 89%) and rarely occurred in the right atrium (2/18 or 11%). One patient had a recurrence of a left atrial myxoma and a second patient of a biatrial myxoma. Three patients had a primary malignant cardiac tumor detectable either in the right atrium (leiomyosarcoma and synovial sarcoma; 2/21) or in the left ventricle (epitheliocellular sarcoma; 1/21). The group of secondary cardiac tumors consisted of different types of metastatic processes which were most often detected in the right atrium (4/5; 80%) and in one case in the left ventricle (1/5; 20%). Overall, the most frequent tumors found in this series were benign cardiac tumors represented by atrial myxoma in 18/30 patient (60%); they resided most often in the left atrium (16/30 or 53% of all tumors). All the cardiac chambers and all main adjacent cardiac vessels must be visualized and inspected carefully to detect the magnitude, origin and recurrence of cardiac tumors.