Tumors: Difference between revisions

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*The second most common primary cardiac tumor.
*The second most common primary cardiac tumor.
*Location: Almost always ventricular (septal or apical).
*Location: Almost always ventricular (septal or apical).
Size: ± 10cm.
*Size: ± 10cm.
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|Papillary fibroelastoma
|Papillary fibroelastoma
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==Malignant tumors==
==Malignant tumors==
Primary malignant tumors are very rare. The most common malignant cardiac tumors are secondary tumors derived from primary diseases (see below). 3% of all patients with cancer receive cardiac metastases through the four " pathways": direct infiltration, haematogenically (through blood), lymph vessels (VCI, pulmonary veins). Malignant tumors have a poor prognosis: In malignant tumors the major risk is of the malignancy itself.
Primary malignant tumors are very rare. The most common malignant cardiac tumors are secondary tumors derived from primary diseases (see table below). 3% of all patients with cancer receive cardiac metastases through the four "pathways": direct infiltration, haematogenically (through blood), lymph vessels (VCI, pulmonary veins). Malignant tumors have a poor prognosis: In malignant tumors the major risk is of the malignancy itself.


{| class="wikitable" cellpadding="0" cellspacing="0" border="0" width="600px"
{| class="wikitable" cellpadding="0" cellspacing="0" border="0" width="600px"
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|-
!left atrium
!left atrium
myxoma
|
trombus
*Myxoma
papillary fibro - elastoom
*Thrombus
sarcoma
*Papillary fibroelastoma
*Sarcoma
|-
|-
!Eight atrium
!Eight atrium
myxoma
|
angiosarcoma
*Myxoma
lymphoma
*Angiosarcoma
trombus
*Lymphoma
papillary fibro - elastoom
*Thrombus
*Papillary fibroelastoma
|-
|-
!Left ventricular
!Left ventricular
fibroma
|
Rhobdomyoom
*Fibroma
trombus
*Rhabdomyoma
Papillary fibro - elastoom
*Thrombus
*Papillary fibroelastoma
|-
|-
!Right ventricle
!Right ventricle
fibroma
|
Rhabdomyoom
*Fibroma
angiosarcoma
*Rhabdomyoma
lymphoma
*Angiosarcoma
trombus
*Lymphoma
papillary fibro - elastoom
*Thrombus
*Papillary fibroelastoma
|}
|}


===Examples===
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{| class="wikitable" cellpadding="0" cellspacing="0" border="0" width="600px"
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|+ Examples<cite>1</cite>
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|Video
|Video
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|align="center"|[[Image:TrombusRA.jpg|300px]]
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!TrombusRA
!Myxoma LA
!LA myxoma Thrombus RA
!Thrombus RA
|-
|-
!
|Video
!
|
|-
|-
|Video
!Vegetation TV
!Vegetation TV
!
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Latest revision as of 21:53, 7 February 2014

Benign tumors

Usually, a cardiac tumor is benign in nature. A benign tumor has a good prognosis at thrombi. Vegetations and some tumors are the most at risk embolism.

(Primary) Benign tumors
Myxoma
  • Most common primary cardiac tumor (50-75%).
  • Location: 90% atrial (LA 75%), 7% ventricular.
  • Size: 1 - 15cm (usually 5 - 6cm)
Fibroma
  • The second most common primary cardiac tumor.
  • Location: Almost always ventricular (septal or apical).
  • Size: ± 10cm.
Papillary fibroelastoma
  • Most common valve tumor.
  • Location: whole heart, usually aortic valve (35%).
  • Size: ± 1cm.
Lipoma
  • Usually, on the basis of the endocardium.
  • Location: whole heart including valves and pericardium.
  • Size: up to ± 10cm.
Rhabdomyoma
  • Most common benign cardiac tumor in children.
  • Location: usually ventricular, no valve involvement.
  • Size: 1mm - 9cm.
Hemangioma
  • Tumor blood, proliferation endothelial cells
  • Location: whole heart
Lambl's excrescences
  • Valvular choir dd. fibroelastoma, thrombus, vegetation.
  • Location: ventricular side of aortic valve.
  • Size: ± 1cm
Cysts
  • Congenital unnatural body cavity delimited by epithelium.
  • Location: usually in the right atrium (right cardiophrenic corner).
Thrombi
  • Clots of blood by slow blood flow.
  • Location: Left atrial appendage in atrial fibrillation, akinetic myocardial infarction or cardiomyopathies, prosthetic valves or infectious valves, atrial septal ASD/PFO.

 

Malignant tumors

Primary malignant tumors are very rare. The most common malignant cardiac tumors are secondary tumors derived from primary diseases (see table below). 3% of all patients with cancer receive cardiac metastases through the four "pathways": direct infiltration, haematogenically (through blood), lymph vessels (VCI, pulmonary veins). Malignant tumors have a poor prognosis: In malignant tumors the major risk is of the malignancy itself.

Primary malignant tumors
Angiosarcoma
  • Most common primary malignant cardiac tumor
  • Location: 90% right atrium
Rhabdomyosarcoma
  • Second most common primary malignant cardiac tumor, often in children than adults
  • Location: whole heart
Mesothelioma
  • Cover visceral and parietal pericardium, no growth in endocardium.
Secondary malignant tumors
Metastases
  • Melanoma
  • Lung Cancer
  • Breast cancer
  • Sarcoma
  • Renal cell carcinoma
  • Leukemia
  • Lymphoma
  • Oesophagus cancer
  • Hepatocellular carcinoma
  • Thyroid cancer
Overview of the locations of the most common cardiac tumors
Location Tumor
left atrium
  • Myxoma
  • Thrombus
  • Papillary fibroelastoma
  • Sarcoma
Eight atrium
  • Myxoma
  • Angiosarcoma
  • Lymphoma
  • Thrombus
  • Papillary fibroelastoma
Left ventricular
  • Fibroma
  • Rhabdomyoma
  • Thrombus
  • Papillary fibroelastoma
Right ventricle
  • Fibroma
  • Rhabdomyoma
  • Angiosarcoma
  • Lymphoma
  • Thrombus
  • Papillary fibroelastoma
Examples[1]
Video TrombusRA.jpg
Myxoma LA Thrombus RA
Video
Vegetation TV

References

  1. Hamer, J.P.M. “Cardiale massa’s”, in: Hamer/Pieper, ‘Praktische echocardiografie’, (2006), 1e druk 2e oplage, Houten, Bohn Stafleu van loghum, p.198-207.

    [1]