Cardiac Tumours

Primary

• 75% are benign; 25% are malignant
• Myxoma is the most common and 80% originate in the left atrium
• Other benign tumours include papillary fibroelastoma and lipoma
• Malignant tumours are sarcomas

Secondary

• Secondary tumours reach the heart by metastasis (primary usually lung and breast) or direct extension and are 20 times more common than primary tumours. 
• Renal, adrenal and liver cancers can invade via the IVC

Presentation
Usually vague with constitutional symptoms but can be dramatic including syncope, CVA, HB, VT and sudden death.

Investigations

TTE and TOE

CT and Cardiac MRI

Biopsy and surgically derived tissue for histology

Management

Myxoma should be surgically removed to reduce embolic events

Fibroelastomas should be excised is highly mobile

If surgical risk is high anti platelet or anticoagulation should be considered

Malignant tumours are not amenable to curative surgical excision