Cardiac Masses and Tumours

Abstract

Cardiac tumours represent a rare but important cause of morbidity and mortality in clinical cardiology and are often challenging for diagnostic cardiac imaging. There is a broad spectrum of differential diagnoses for cardiac masses (Table 29.1). This chapter is mainly focussed on the diagnosis of primary and secondary cardiac tumours and intra-cardiac thrombi. Primary cardiac tumours are rare, with a prevalence between 0.001 and 0.3%.1 Based on autopsy studies, secondary cardiac tumours, including metastases from distant malignomas or local invasion from neoplasms in the chest, are at least 20 times more common.2 Three quarters of the primary cardiac tumours are benign, and nearly half of those are myxomas, the rest being lipomas, papillary fibroelastomas, haemangiomas, and rhabdomyomas. Ninety-five percent of the malignant primary cardiac tumours are sarcomas, and the more common types are angiosarcomas (37%), undifferentiated sarcomas (24%), malignant fibrous histiocytomas (11–24%), leiomyosarcomas (8%), and osteosarcomas (3–9%).3