Cardiac Tumors: Classification and Epidemiology

Abstract

The precise prevalence of primary cardiac tumors in the general population is mostly based on old postmortem studies and it is generally agreed that autopsy prevalence of primary cardiac tumors is 1/2,000 and that of secondary cardiac tumors is 1/100 autopsies, with a secondary/primary cardiac tumors ratio of 20:1.According to the last WHO classification, cardiac tumors are grouped in three categories, i.e., benign tumors and tumor-like lesions; malignant tumors; and pericardial tumors.As far as malignant cardiac tumors are concerned, there is no a grading system specifically referring to malignant cardiac tumors and we have to refer to the criteria used for soft tissue neoplasms. Three grades of malignancy are usually recognized: G1, low grade; G2, intermediate grade; G3, high grade. The FNCLCC system is based on a score obtained by evaluating three features: tumor differentiation, mitotic rate, and amount of tumor necrosis.Concerning the epidemiology and prevalence of various tumor histotypes, the data are also not uniform in the literature and the published numbers of primary cardiac tumors frequently reflect a referral bias. According to the data collected at the University of Padua, among the consecutive 210 primary cardiac tumors, only 11 % were malignant and 89 % benign.Among the primary benign cardiac tumors, the majority are myxomas, followed by papillary fibroelastomas and other less frequent histotypes. The prevalence of cardiac tumors differs among age groups: myxoma is the most common cardiac neoplasm in adults, whereas in the childhood fibromas and rhabdomyomas are the most frequent ones.As far as malignant primary cardiac tumors, indifferentiated sarcomas, leiomyosarcoma, malignant fibrohistiocytoma, and angiosarcoma ranked are the most prevalent. As far as metastatic cardiac tumors, lung carcinoma was by far the most common in our experience, followed by lymphoma, leukemia, breast, hepatic and kidney carcinoma, among the others.KeywordsMalignant MesotheliomaMalignant Fibrous HistiocytomaCardiac TumorVentricular Free WallCardiac MyxomaThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.