Cardiac tumors: a current clinical and pathological perspective

Cardiac tumors, primary or secondary, are rare but important cardiovascular abnormalities. Their potentially lethal course and the possibility of cure with propitious excision makes their diagnosis challenging and consequential. Therefore, in order to achieve diagnostic and therapeutic adequacy, clinicians should be knowledgeable of cardiac tumor pathology as well as their frequently atypical clinical presentations. For centuries, neoplasias of the heart have been considered a rarity and a postmortem diagnostic curiosity. Their incidence in autopsy series varies between 0.0017 and 0.19% in unselected patients (Heath, 1968; Straus et al., 1945; Wold et al., 1980). Antemortem recognition of intracardiac tumors by clinical and electrocardiographic findings was not recognized until 1934 (Barnes et al., 1934). In 1951, the diagnosis of an intracavitary left atrial tumor was confirmed with angiography (Goldberg et al., 1952), and the first successful excision of a heart tumor, a left atrial myxoma, was reported in 1955 (Crafoord, 1955). It was only later in the 1970s, when M-mode and 2-D echocardiography became available together with other imaging techniques such as CT and MRI, that antemortem diagnosis of intracardiac tumors became more feasible.