Skip to Main Content


  • • Most common cardiac neoplasm is a metastatic lesion (carcinoma of lung or breast, sarcoma, melanoma)

    • 75% of primary cardiac neoplasms are benign (myxoma, rhabdomyoma)




  • • 75% of benign primary cardiac tumors

    • Appearance ranges from smooth, round, firm encapsulated mass to loose conglomeration of gelatinous material

    • Most attached to fossa ovalis of left atrial septum; some may occur in right atrium or ventricles

    • Histologically, contains various mesenchymal cells

    • -Abnormal DNA ploidy may correlate with recurrence

    • Papillary fronds attached to aortic valve associated with cerebral and coronary embolization

    • Fibromas occur in pediatric patients, slowly invading conduction system

    • -Can cause sudden death from arrhythmias




  • • Primary tumors of heart are rare

    • -0.002-0.3% of autopsies

    • Occur in any age


Symptoms and Signs


  • • Presentation depends on type and location of tumor

    Malignant tumors: Rapidly progressive congestive heart failure from valvular or myocardial infiltration

    Myxoma: Fever, weight loss, anemia, systemic embolization

    • Mitral stenosis can occur from tumor causing characteristic early diastolic sound "tumor plop"

    • Fibromas can cause sudden death from arrhythmias


Laboratory Findings


  • Myxoma: Abnormal ESR, gamma globulin, liver aminotransferases

    • Anemia, thrombocytopenia common in many tumors

    Transesophageal echocardiography: Procedure of choice

    • MRI and CT may be helpful in infiltrative lesions


  • • Evaluate for other sites of tumor


  • • Physical exam

    • Echocardiography, possibly transesophageal

    • MRI for invasive lesions


  • Most benign lesions: Resectable/curable


    • -Cardiopulmonary bypass required

      -Resect tumor and rim of normal tissue around attachment stalk

    • Surgery for cardiac sarcomas and metastatic lesions is usually for diagnosis; occasionally palliative

    • Orthotopic heart transplantation (rarely)






  • • Suspected myxoma, consider repair




  • • Embolization during tumor manipulation




  • • Operative mortality < 1%

    • Long-term survival for malignant cardiac lesions remains poor




  • • Resect rim of normal tissue around attachment stalk to prevent recurrence of myxomas



Araoz PA et al. CT and MR imaging of primary cardiac malignancies. Radiographics. 1999;19:1421.  [PubMed: 10555666]
Lobo A et al. Intracardiac masses detected by echocardiography: case presentation and review of the literature. Clin Cardiol. 2000;23:702.  [PubMed: 11016023]
Shapiro LM. Cardiac tumours: diagnosis and management. Heart. 2001;85:218.  [PubMed: 11156679]
Gavrielatos G. et al. Large left atrial myxoma presented as fever of unknown origin: a challenging diagnosis and a review of the literature. Cardiovascular Pathology. 2007;16(6):365-7.  [PubMed: 18005878]

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.


About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessSurgery Full Site: One-Year Subscription

Connect to the full suite of AccessSurgery content and resources including more than 160 instructional videos, 16,000+ high-quality images, interactive board review, 20+ textbooks, and more.

$995 USD
Buy Now

Pay Per View: Timed Access to all of AccessSurgery

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.