125 - Primary Benign, Malignant, and Metastatic Tumors of the Heart

Abstract

Cardiac masses are often the subject of case reports because of their rarity. However, because they are so infrequent, they often challenge the diagnostic skills of even the most experienced physician. Improvements in echocardiography, including real-time three-dimensional (3D) echocardiography, as well as cardiac computed tomography (CT) and cardiac magnetic resonance imaging (CMRI), have enabled cardiologists to better refine the differential diagnosis of cardiac masses. Cardiac masses are generally first noted antemortem with echocardiography. The sensitivity and specificity of echocardiography for the detection of cardiac masses is difficult to precisely discern because the incidence of cardiac tumors is low, especially for primary tumors. Data from several small case series, however, offer some insight about the diagnostic yield from two-dimensional (2D) echocardiography. Three-dimensional (3D) echocardiography appears to have incremental yield when used as an adjunct to 2D echocardiography. Its value lies in its ability to provide additional information about the location of a mass, its size, site of attachment, and potential approach for surgical resection. Another way in which 3D echocardiography may be helpful is in determining the size of cardiac masses. This has clinical importance because the diameter of a mass, whether it is a vegetation, thrombus, or tumor, has important implications for patient prognosis and embolic potential. Advanced cardiac imaging is now more readily available for diagnostic evaluation of cardiac masses. CMRI is the most commonly used imaging modality after echocardiography; at present, cardiac CT has a more limited role.