Common Cardiac Tumor Research Articles

Atrial myxoma inducing acute stroke and mimicking ST-elevation myocardial infarction: A case report

Atrial myxoma is the common cardiac benign tumor, which is typical leading to three major symptoms, including obstructive symptoms, constitutional symptoms, and embolic symptom. The abnormal blood flow induced by atrial myxoma may play a critical role to cause severe and irreversible neurologic complications, such as recurrent transient ischemic attack and stroke. It is an important diagnosis for physicians to keep in mind when patient presenting with stroke symptoms. Here, we report a case presented with acute onset loss of consciousness and flaccid hemiplegia on left side. The electrocardiogram revealed ST segment elevation from precordial leads V4 to V6 and limb leads I and II. The patent coronary artery was noted and cardiac ultrasound revealed an atrial myxoma, finally. We highlight the neurological and cardiac symptoms by atrial myxoma for physicians to early diagnosis and timely intervention.

Innate immunity in cardiac myxomas and its pathological and clinical correlations.

Cardiac myxomas are the most common benign cardiac tumor. We investigated the immunohistochemical properties of 11 surgically excised cardiac myxomas, in order to analyze the correlation between macrophages and mast cell populations and clinical parameters. CD68+/CD163−/iNOS− (M0) cells represent the most abundant macrophage phenotype; however, CD68+/CD163+ cells (M2) were also frequent. CD68+/iNOS+ (M1) elements were rare. Mast cells, defined as a population of c-kit (CD117)+ and/or tryptase+ cells were also detected. Statistical analysis showed significant correlations between c-kit (CD117)+ and tryptase, CD68 and erythrocyte sedimentation rate (ESR), ESR and red blood cell count (RBC), and prothrombin time and platelet count. The inverse correlation between RBCs in peripheral blood and ESR suggested that anemia associated with chronic inflammatory disease is a noncasual event in patients suffering from cardiac myxoma. Mechanical hemolysis may be only a minor component of anemia, according to the lack of correlation between echographic surface and RBCs. Moreover, tumor size did not correlate with ESR, showing that inflammatory state may depend from both tumor cells population and inflammatory infiltrate. In the future, modulation of macrophage polarization in cardiac myxomas might represent important therapeutic target.

Regression of Neonatal Cardiac Rhabdomyoma in Two\xa0Months Through Low-Dose Everolimus Therapy: A Report of Three Cases

Cardiac rhabdomyoma (CR) is the most common cardiac tumor in newborns. Approximately 75% of cases are associated with tuberous sclerosis complex. Although these tumors usually spontaneously regress after 2 years of age, they can be life-threatening when they obstruct major cardiac inflow or outflow pathways. Everolimus is an inhibitor of the mammalian target of rapamycin, reducing its production of the proteins harmartin and tuberin. Everolimus has demonstrated a remarkable suppression effect in children with tuberous sclerosis complex at doses of 4.7–5.6 mg/M2/day and serum trough levels of 5–15 ng/mL. Since 2012, five case reports of neonates with CR have also reported the tumor-regressing effect of everolimus. However, the optimal dosage for neonates is still unknown. Over the past 2 years, we have deliberately used a low dose everolimus regimen (0.3–0.67 mg/M2/day) in three neonates with large CRs, in an effort to maintain serum trough levels at 3–7 ng/mL. In all three cases, the tumors regressed smoothly within 2 months. Regarding the drug’s side effect of predisposing patients to infection, we observed that adenovirus pneumonia occurred in one case at 3 months of age, and chicken pox occurred in another case at 9 months of age; both recovered smoothly. Our three cases of neonatal CR demonstrate that a low-dose everolimus regimen is an effective treatment for tumor regression.

Everolimus treatment of a fetal intracardiac rhabdomyoma not associated with the tuberous sclerosis complex: a case report

Abstract Introduction Benign cardiac rhabdomyomas are the most common cardiac tumors in fetuses and children. They are most often located in the ventricles and may disturb myocardial function, the severity correlating with location and size of the tumor. Rhabdomyomas are commonly associated with the tuberous sclerosis complex (TSC) and are the first clinical manifestation in 50–80% of the cases [Isaacs H Jr. Fetal and neonatal cardiac tumors. Pediatr Cardiol. 2004;25:252–73, Colosi E, Russo C, Macaluso G, Musone R, Catalano C. Sonographic diagnosis of fetal cardiac rhabdomyomas and cerebral tubers: a case report of prenatal tuberous sclerosis. J Prenat Med. 2013;7:51–5]. Several authors have documented the sensitivity of TSC-associated rhabdomyomas to everolimus treatment [Hoshal SG, Samuel BP, Schneider JR, Mammen L, Vettukattil JJ. Regression of massive cardiac rhabdomyoma on everolimus therapy. Pediatr Int. 2016;58:397–9, Mlczoch E, Hanslik A, Luckner D, Kitzmüller E, Prayer D, Michel-Behnke I. Prenatal diagnosis of giant cardiac rhabdomyoma in tuberous sclerosis complex: a new therapeutic option with everolimus. Ultrasound Obstet Gynecol. 2015;45:618–21, Tiberio D, Franz DN, Phillips JR. Regression of a cardiac rhabdomyoma in a patient receiving everolimus. Pediatrics. 2011;127:e1335–7]. The present study provides convincing evidence of successful everolimus therapy in a newborn without the TSC complex. Case presentation A cardiac rhabdomyoma measuring 35 × 28 × 24 mm was seen in a fetus in pre- and postnatal echocardiography. There was no family history for TSC and amniocentesis showed no mutations in the TSC1/TSC2 genes. Off-label treatment with everolimus began when the neonate was 11 days old and was discontinued when the infant was 11 months old after echocardiography showed marked regression of tumor size and improvement of the tricuspid valve insufficiency. Echocardiography 3 months later showed an increase in size to 13.2 × 9 mm, so that everolimus therapy was re-instated. The next echocardiography, 10 weeks later, showed renewed regression of tumor size and a residual moderate tricuspid valve insufficiency under everolimus therapy. Discussion The present report of a rhabdomyoma in a newborn without an association with TSC is of interest because it identifies a treatment effect of everolimus. A medical approach in patients with cardiac decompensation due to intracardiac rhabdomyomas offers an attractive alternative to surgery.

Microinsertions in PRKACA cause activation of the protein kinase A pathway in cardiac myxoma.

Cardiac myxoma is the most common cardiac tumour. Most lesions occur sporadically, but occasional lesions develop in patients with Carney complex, a syndrome characterized by cardiac myxoma, spotty pigmentation, and endocrine overactivity. Two-thirds of patients with Carney complex harbour germline mutations in PRKAR1A, which encodes the type I regulatory subunit of protein kinase A (PKA). Most studies have not found a mutation in PRKAR1A in sporadic cardiac myxoma cases. Recent studies identified frequent mutations in PRKACA, which encodes the catalytic subunit of PKA, in cortisol-secreting adrenocortical adenoma cases. To determine whether the PRKACA mutation is involved in the tumourigenesis of cardiac myxoma, we performed Sanger sequencing of 41 specimens of sporadic cardiac myxoma to test for the presence of mutations in the coding regions and intron-exon boundaries of PRKACA. Mutations were identified in four cases (9.7%). In contrast to the point mutations identified in adrenocortical adenoma, all mutations were in-frame microinsertions of 18-33 bp clustered in exons 7 and 8. The mutated PRKACA proteins lost their ability to bind to PRKAR1A, and thereby lead to constitutive activation of the PKA pathway. Together with previous reports of PRKAR1A mutations in syndromic cardiac myxoma, our study demonstrates the importance of the PKA pathway in the tumourigenesis of cardiac myxoma. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

Fibroelastoma: a rare cause of cardioembolic stroke in the young

Objectives The investigation and management of stroke in a young person remains challenging. The majority do not have traditional risk factors and the mechanism of stroke can be unclear. We present a case of a 34-year-old East Timorese woman who had major sequential strokes caused by a cardiac fibroelastoma. We reviewed the current literature on this rare condition and its cardioembolic stroke propensity. Methods We searched PubMED/OVID databases with the term ‘fibroelastoma’. We evaluated the epidemiology, diagnosis, complications and treatment of fibroelastoma. Results Fibroelastoma is the second most common cardiac tumour arising from or attached to valvular structures.1 Autopsy series estimate an incidence of 0.33%.2 With advances and availability of cardiac imaging, these tumours are more readily detected even in the asymptomatic patient. Transoesophageal echocardiogram (TOE) and cardiac MRI have greater resolution in identifying the tumour, as a proportion are missed on transthoracic echocardiogram (TTE).3 Fibroelastoma has great thrombogenic tendency; systemic embolisation is high with stroke risk estimated at 30%–40% per annum3,4, making stroke the most frequently encountered presentation of fibroelastoma followed by arrhythmia, heart failure and sudden cardiac death. High risk tumour features are those that are (1) freely mobile, (2) greater than 1 cm and (3) located on the left side of heart.2 In symptomatic patients there is compelling evidence to support surgical excision of the tumour in a timely manner. In those asymptomatic, the data is unclear. However given the relatively safe surgical profile and detrimental consequences, it is advisable to operate. Anticoagulation is prudent while awaiting surgery. Conclusions Fibroelastoma is a rare but important cause of cardioembolic stroke. Often these tumours are missed on routine TTE. A high index of suspicion is needed and young patients with cardioembolic strokes should be considered for TOE and cardiac MRI. Treatment with surgical resection is warranted to reduce future risk of stroke.

Cardiac tumors in children: A 20-year review of clinical presentation, diagnostics and treatment.

The use of new imaging techniques has contributed significantly to earlier diagnosis and treatment of cardiac tumors. The aim of the study was to analyze data from children with cardiac tumors in terms of clinical presentation, the role of noninvasive diagnostic procedures and the long-term outcome. The data analyzed retrospectively concerned 30 children in whom cardiac tumors were diagnosed from January 1995 to July 2015. The cardiac evaluation included a review of the subjects' medical records and medical history, a physical examination, standard 12-lead electrocardiography, echocardiography and 24-h Holter ECG monitoring at the time of diagnosis and at 6-12 month intervals during the follow-up at the authors' outpatient clinic. Most of the children did not need cardiac surgery; surgical tumor excision was necessary in 3 cases only. There was 1 death in the follow-up period. Rhabdomyoma was diagnosed in 22 cases, and in 16 of them tuberous sclerosis was confirmed during the follow-up period. In the remaining 8 cases, fibroma was the most likely diagnosis. The symptomatology of cardiac tumors in children can vary greatly, from the absence of any symptoms up to heart failure and respiratory distress indicating the need for surgical intervention. The diagnosis of cardiac tumors relies almost exclusively on noninvasive imaging techniques. The observations in this study confirm the fact that the most common cardiac tumor in children is rhabdomyoma, which may disappear spontaneously. Most patients with cardiac tumors do not require treatment.

Right Atrial Myxoma Versus Highblood Pressure And Coronary Artery Disease In The Development Of Chest Pain And Dyspnoea

Myxomas are the most common cardiac tumors but Right atrial myxoma is very less common among myxomas. Clinical presentation varies considerably. We report about a 52 years old man who was admitted in our unit for chest pain, dyspnoea which developed progressively among the last 4 years. Investigatations found near a left ventricular dysfunction a large right atrial myxoma, known 10 years ago. Management involved a CABG and surgical removal of this tumor anatomo- pathological as myxoma described. The patient did well 3 months after this procedures.

Management of a Heart Myxoma Through a Right Thoracotomy in a Patient With a Previous Sternotomy

Myxoma is the most common benign cardiac tumor, presenting most frequently in the left atrium. Median sternotomy has been traditionally used to provide access to the heart and the mediastinal structures in cardiac operations. Recently, right thoracotomy and minithoracotomy have been used as an alternative. We present a case of a patient with left atrial myxoma, who had been subjected to coronary artery bypass graft 2 years ago. The previous full median sternotomy urged the need for another approach. A right lateral thoracotomy with one lung ventilation was chosen, offering excellent access to the heart and mediastinum. The patient was set under cardiopulmonary bypass and cardioplegia and the mass was excised through a left atrial incision. The perioperative course was free of complications. We suggest that right thoracotomy is a safe and efficient way of treating cardiac tumors in selected patients, when median sternotomy is considered complicated, not possible or contraindicated. J Med Cases. 2016;7(2):52-53 doi: http://dx.doi.org/10.14740/jmc2405w

Spontaneous implantation of a left atrial myxoma into the left ventricle

Myxomas are one of the most common cardiac tumors. In 70–80% of cases they are located in the left atrium, 10–20% in the right atrium and in less than 10% in ventricles. We report a case of a 60-year-old patient after myocardial infarction of the posterior-inferior-lateral wall and subsequent percutaneous coronary interventions, who presented with symptoms of unstable angina. Based on standard criteria including cardiac enzymes acute coronary syndrome was excluded. Transthoracic echocardiogram showed hypokinesis of the lateral wall, normal left ventricular ejection fraction of 56%, left ventricular hypertrophy, enlarged heart chambers and moderate mitral regurgitation. Additional two masses were visualized - one of 3.1 x 1.4 cm size growing from interatrial septum in the area of fossa ovalis in the left atrium, second of 1.2 x 0.4 cm connected to the chordae tendinae in the left ventricle. On transthoracic echocardiography a distal part of the left atrial structure spontaneously fell into the left ventricle hitting the tendinae. Successful surgical removal of both masses followed by pathological evaluation confirmed the diagnosis of myxomas.

Characterization of surgical cardiac tumors.

The primary tumors of the heart are extremely rare. There are divided to benign, malignant and metastatic. Metastatic cardiac tumors are more common. The incidence in contemporary echocardiographic series is reported at a higher frequency of 0.15%. 75% of cardiac tumors are benign; approximately half of these are cardiac mommas. The malignant cardiac tumors are mostly histopathologically undifferentiated, followed by leiomyosarcomas and angio-sarcomas. Cardiac tumors have a wide range of unique clinical presentation. Even the most benign and smallest tumor can lead to significant morbidity and mortality. The clinical presentations of the primary cardiac tumors are due to: blood flow obstruction, tumor embolization and constitutional symptoms. Clinical presentations can be varied and may resemble coronary disease, pericarditis, cardiomyopathy or valve malfunction. The recent technological advances in non-invasive imaging modalities such as echocardiography and cardiac magnetic resonance imaging is rapidly increases the early diagnosis and management approach. In this review we aim to summarize the characterization of the most common cardiac tumors. Early recognition and treatment provided the best results (Tab. 2, Fig. 6, Ref. 66).

MRI Verification of a Case of Huge Infantile Rhabdomyoma

Introduction:Cardiac rhabdomyoma is type of benign myocardial tumor that is the most common fetal cardiac tumor. Cardiac rhabdomyomas are usually detected before birth or during the first year of life. They account for over 60% of all primary cardiac tumors.Case report:A 6 month old child with coughing and obstruction in breathing, was hospitalized in the Pediatric Clinic in UCCK, Pristine. The difficulty of breathing was heard and the pathological noise of the heart was noticed from the pediatrician. In the echo of the heart at the posterior and apico-lateral part of the left ventricle a tumoral mass was presented with the dimensions of 56 × 54 mm that forwarded the contractions of the left ventricle, the mass involved also the left ventricle wall and was not vascularized. The right ventricle was deformed and with the shifting of the SIV on the right the contractility was preserved. Aorta, the left arch and AP were normal with laminar circulation. The pericard was presented free. Radiography of thoracic organs was made; it resulted on cardiomegaly and significant bronchovascular drawing. It was completed with an MRI and it resulted on: Cardiomegaly due to large tumoral mass lesion (60×34 mm) involving lateral wall of left ventricle. It was isointense to the muscle on T1W images, markedly hyperintense on T2W images. There were a few septa or bant like hypointensities within lesion. On postcontrast study it showed avid enhancement. The left ventricle volume was decreased. Mild pericardial effusion was also noted. Surgical intervention was performed and it resulted on the histopathological aspect as a huge infantile rhadbomyoma.Conclusion:In most cases no treatment is required and these lesions regress spontaneously. Patients with left ventricular outflow tract obstruction or refractory arrhythmias respond well to surgical excision. Rhabdomyomas are frequently diagnosed by means of fetal echocardiography during the prenatal period.

Cardiac Myxomas: A 50-Year Experience With Resection and Analysis of Risk Factors for Recurrence

Myxomas are the most common cardiac tumors, but there are insufficient data regarding long-term survival and recurrence rates. Our objective was to examine late results and attempt to determine a strategy for recurrence monitoring, as there are no recommended guidelines at present. We performed a retrospective analysis of 194 patients (mean age 57.2 ± 15.6 years; 62.4% female) undergoing resection of cardiac myxoma from June 1955 to June 2011. The left atrium (n= 155, 80%) was the most common location, and the mean tumor size was 4.3 ± 2.1 cm by 3.2 ± 1.6 cm by 2.1 ± 1.3 cm. Dyspnea (n= 68) and palpitations (n= 57) were the most common complaints, and 28 patients (14.4%) were asymptomatic. The tumor was exposed through the respective atria in the majority of patients (n= 187). Bypass and cross-clamp times were 59.1 ± 33.4 minutes and 35.2 ± 21.7 minutes, respectively. Two thirds of the tumors were excised with an endocardial button, and the rest were resected at the base of the stalk. Operative mortality was 0.5%. Ten, 20 and 30-year survival was 77%, 52% and 34%, respectively, which was comparable to an age-matched general population (p= 0.191). Older age at operation was the only significant predictor of subsequent mortality (p < 0.001). There was no significant difference in survival when patients were stratified by sex (p= 0.784), location of tumor (p= 0.087), the largest tumor dimension (p= 0.257) or surgical technique (endocardial button versus base of the stalk, p= 0.502). Tumors recurred in 11 patients; freedom from tumor recurrence was 92%, 91%, and 86% at 10, 20, and 30 years, respectively. Younger age at surgery (hazard ratio 0.94, p= 0.002), smaller tumor dimension (hazard ratio 0.58, p= 0.011), and tumor localized to the ventricles (hazard ratio 7.29, p= 0.013) were predictors of recurrence. Cardiac myxomas can be resected with low early mortality and excellent late survival. Tumor recurrence is more likely to occur in the first 10 postoperative years, especially in younger patients, patients with a smaller tumor mass, or tumor location in the ventricle. Patients with these findings require closer imaging surveillance in the first decade after resection.

Non-valvular left ventricular papillary fibroelastoma in a patient with recurrent stroke.

A 69-year-old gentleman presented with sudden-onset dizziness and diplopia. Clinical examination findings were suggestive of posterior circulation stroke. He was found to be in atrial flutter on admission, reverting spontaneously to sinus rhythm. Three weeks before admission, he was admitted to a different hospital with anterior circulation stroke, which left him with minor residual weakness. He was found to be in sinus rhythm during that admission and was discharged home on dual-anti platelet therapy. Transthoracic echocardiogram (TTE) performed to exclude a cardiac source of emboli showed a highly mobile echogenic structure in the left ventricular outflow tract (LVOT) attached to the interventricular septum (Fig. 1A and Video 1). Subsequent transoesophageal echocardiogram (TOE) confirmed a highly mobile mass in the LVOT, which appears to be prolapsing through the aortic valve (Fig. 1B, C and Videos 2, 3). The left atrium and appendage are free of spontaneous contrast or thrombus and there are no atherosclerotic plaques noted in the aorta. Given the history of recurrent stroke, the highly mobile nature of the mass and its position in the LVOT, the patient was referred for urgent surgery. The patient underwent complete surgical excision of the mass (Fig. 1D), which was then confirmed to be benign papillary fibroelastoma (PFE) on histopathology. PFE is the second most common cardiac tumour which usually originate from the valvular endothelium. PFE arising from this non-valvular location is exceptionally rare. When present in such a location, they are often mistaken for myxoma from TTE and usually warrants further imaging such as TOE or cardiac MRI to confirm diagnosis. Surgery is curative in most cases and prompt referral should be considered (1). Open in a separate window Figure 1 (A) Transthoracic echocardiogram (PLAX view) showing the mass in the LVOT attached to the inter-ventricular septum. (B) Transoesophageal echocardiogram confirming the mass measuring 1.1×1.1 cm in the LVOT attached to the inter-ventricular septum. (C) Transoesophageal echocardiogram showing the mass prolapsing through the aortic valve. (D) Intraoperative picture showing the jelly-like mass attached to the inter-ventricular septum.

The masquerading myxoma – Presentation as acute STEMI

Primary cardiac neoplasms are very rare, with an incidence less than 0.2% in unselected patients at autopsy. Of these, cardiac myxomas are the most common benign cardiac tumors in the adult. Atrial myxomas are a rare source of coronary artery embolism. Coronary embolism as the first presentation of cardiac myxoma is extremely uncommon. We report a case of acute inferior wall ST elevation myocardial infarction (STEMI) caused by embolization of the tumor fragment from left atrial myxoma into the left circumflex coronary artery. The patient was successfully treated by percutaneous coronary intervention with catheter aspiration of the embolized tumor fragment followed by surgical excision of the tumor.

Cardiac myxoma: An uncommon cause of recurrent stroke in uncommon age

Atrial fibrillation is the most common cause of cardiogenic emboli in stroke, responsible for over 50% cases of total stroke patients. Myxoma is responsible only in few cases. A stroke caused by left atrial myxoma commonly occur in young females. This patient presented with the repeated attack of stroke in the age of 80 years. However, it is the most common benign cardiac tumor found more frequently. In young adults with stroke or transient ischemic attack than in older patients. Age of the patient and unusual cause of recurrent stroke make this case report interesting. An 80-year-old male with no other conventional vascular risk factors such as hypertension, diabetes, or hyperlipidemia presented with left hemiparesis. Infarction over the right middle cerebral artery was disclosed on a magnetic resonance imaging study. The patient was a known case of right hemiparesis 3 years back, which was improved. The cause of repeated attack of stroke was left atrial myxoma, diagnosed by two-dimensional echocardiography.

The mysterious pathways of cardiac myxomas: a review of histogenesis, pathogenesis and pathology.

Cardiac myxoma is the most common benign cardiac tumour, localized generally in the left atrium. The majority of cardiac myxomas occur sporadically, while a relatively small proportion of cases develop as a part of Carney complex syndrome. Currently, the histogenesis of myxoma is poorly understood; however, the mesenchymal and endothelial properties of myxoma cells suggest that a clearer understanding of tumour origins can be achieved through a detailed investigation of heart development and endocardial histogenesis. Growing evidence appears to indicate the reactivated expression in cardiac myxoma of genes encoding heart precursor markers, although the exact mechanisms have not yet been described. In this paper we review the most recent scientific literature concerning cardiac embryology and relate this to recent advances in our understanding of the histogenesis of cardiac myxoma. Moreover, given that much of the literature regarding myxoma is of single case reports, we review progress in our knowledge of the pathology and pathogenesis of this condition.

Incidental finding of cardiac papillary fibroelastoma of the left ventricular outflow tract, associated with rheumatic mitral and tricuspid stenosis

Cardiac papillary fibroelastomas (CPFs) are one of the most common benign cardiac tumours. However, due to their location and pedunculated nature, they are associated with substantial complications secondary to systemic embolization or coronary ostial obstruction. Surgical resection should be offered to all patients when the mass is >1 cm in diameter. Valve-sparing excision produces good long-term results in most instances. We present the case of a young female scheduled for elective mitral and tricuspid valve replacement and maze procedure for chronic atrial fibrillation. A CPF was incidentally discovered during routine intraoperative transoesophageal echocardiography with an unusual location; at the left ventricular outflow tract.

Right atrial cardiac rhabdomyoma with premature foramen ovale restriction: A case report.

Fetal cardiac rhabdomyoma is the most common cardiac tumor in fetuses. However, this benign tumor can cause hemodynamic repercussions and intrauterine fetal mortality. The present study reports a case of rare fetal cardiac rhabdomyoma located in the right atrium, accompanied by premature restriction of the foramen ovale and moderate pericardial effusion, as determined by tomographic ultrasound imaging (TUI). Fetal mortality subsequently occurred late in the second trimester of pregnancy and the diagnosis was confirmed by pathology. The present study discusses the occurrence and diagnosis of this rare abnormality. TUI mode with spatio-temporal image correlation offline imaging provides the physician with clear views of abnormal intracardiac structures in the beating heart. With improvements in sonographic technology, the diagnosis of fetal cardiac rhabdomyoma may be easier and more accurate in the clinical arena.

Pediatric cardiac tumors: clinical and imaging features.

Cardiac tumors in children are rare, are more commonly benign, and differ in types when compared with those in adults. Rhabdomyoma, teratoma, and fibroma are the most common cardiac tumors in fetuses and neonates. In infants and children, the most common cardiac tumors are rhabdomyoma and fibroma, which are benign primary cardiac tumors, whereas in adults, thrombus is the most common cardiac mass and myxoma is the most common primary cardiac tumor. Sarcomas are the most common primary malignant cardiac tumors in both children and adults. Metastatic cardiac tumors are less common in children than in adults and include sarcoma, lymphoma, testicular cancer, and Wilms tumor. Patients with cardiac tumors can be asymptomatic or may present with murmur, arrhythmia, heart failure, or sudden death. Echocardiography is the primary modality for initial evaluation of symptomatic patients. Cardiac magnetic resonance imaging provides further characterization of cardiac masses and tumors for diagnostic purposes and can be used to assess cardiac and extracardiac involvement for treatment planning. Treatment varies from conservative management or surgical resection to transplantation, depending on the diagnosis and the patient's symptoms. Rhabdomyoma typically regresses spontaneously during early childhood and does not require surgical intervention if asymptomatic. However, fibroma is generally resected because it does not regress. An understanding of the types of cardiac tumors that occur in infants and children, their clinical implications and associations, and their imaging appearances will facilitate patient management.