Primary cardiac tumors: experience at the University of Minnesota

A review of all primary cardiac tumors seen at the University of Minnesota or entered in the Registry of Cardiovascular Disease, affiliated with the University of Minnesota, between 1959 and 1989. Of a total of 124 primary cardiac tumors, 103 (83%) were benign and 21 (17%) were malignant. Atrial myxomas (51 cases) accounted for 42% of all tumors and 50% of benign neoplasias. The remaining 51 benign tumors were, in order of frequency: rhabdomyomas, 14 (13%), papillomas, 12 (11%), fibromas, 9 (9%), hamartomas, (4%), teratomas (2%), lipomas (2%), mesotheliomas (2%), fibroelastomas, hemangiomas, glomangiomas, and a few others. The 21 malignant tumors, all sarcomas, were, in order of frequency: rhabdomyosarcomas, 6 (29%), angiosarcomas, 4 (19%), myxosarcomas, 3 (14%), fibrosarcomas, 2 (10%), and one each leiomyosarcoma, reticulum cell sarcoma, and liposarcoma. There were 3 cases of spindle cell sarcoma (14%) originating in the great vessels: 1 in the pulmonary artery and 2 in the aorta. The prognosis of the resected benign tumors was good, with no complications of recurrences for up to 15 years of follow-up. Tumors that could not be excised included mostly rhabdomyomas, in newborns, and cavernous hemangiomas involving most of the heart, with poor prognosis. Malignant tumors of the heart had a very poor prognosis, even when operated on promptly after diagnosis. The mean survival time of these patients was 5 months after resection, even when followed with chemotherapy and/or radiation; 26% of the tumors had already metastasized at the time of operation. Extensive resections in malignant tumors did not render satisfactory results.