Long-Term Outcomes of Primary Cardiac Tumors by Histological Subtype

Primary cardiac tumors are rare, and the prognostic impact of their histological subtypes remains poorly understood. We assessed the clinical outcomes of benign and malignant tumors using long-term follow-up data from pathologically confirmed cases.

We retrospectively analyzed 42 consecutive patients diagnosed with primary cardiac tumors between 2007 and 2022 at a single center. Among them, 41 patients who underwent surgical resection were followed longitudinally and included in the present study. Clinical features, tumor distribution, and outcomes were assessed by histological type, with particular focus on long-term prognosis. Histological diagnoses were confirmed in each case. Myxomas accounted for 73% (n=30), diffuse large B-cell lymphomas (DLBCLs) for 7% (n=3), and other benign tumors for 20% (n=8) of cases. Myxomas were predominantly located in the left atrium and showed excellent long-term outcomes, with no recurrence or tumor-related deaths over a median follow-up of 12.8 years. In contrast, all patients with DLBCL had right-sided tumors and died within 2 years due to disease progression despite surgery and chemotherapy. Kaplan-Meier analysis showed significant differences (P<0.001) in survival among tumor types, with DLBCL showing uniformly poor outcomes.

Benign cardiac tumors had favorable outcomes, with myxomas showing a particularly excellent prognosis. In contrast, malignant tumors were uniformly associated with early death. Histological subtype may be associated with survival.