Definition
Cardiac tumors are rare neoplastic processes that can originate from any heart tissue. They are divided into primitives (benign or malignant) and metastatic (always malignant).
The primitive cardiac tumors develop from the transformation in the neoplastic sense of the same heart cells, while the metastatic forms are secondary mainly to lung tumors, lymphomas, breast carcinoma, leukemia, melanoma, hepatocellular carcinoma and colon cancer.
Fortunately, benign primitive tumors are more common than malignant ones (3: 1 ratio). Among the primitive benign forms, the myxoma is the most widespread, followed by fibroids, lipomas, papillary fibroelastomas and rhabdomyomas. Angiosarcomas, on the other hand, are the main primitive malignant neoplasm.
Most common symptoms and signs *
- Anemia
- Anorexia
- Arrhythmia
- Ascites
- Asthenia
- Increase in the ESR
- Chills
- Retrosternal burning
- Cachexia
- Cardiomegaly
- palpitations
- Swollen ankles
- Cyanosis
- Dysphagia
- Dyspnoea
- Distension of the neck veins
- Drumstick fingers
- Chest pain
- Articolar pains
- Muscle pains
- Edema
- Hemoptysis
- Hepatomegaly
- Temperature
- Swollen legs
- Hydrops Fetal
- Hypotension
- orthopnea
- Pallor
- Weight loss
- petechiae
- thrombocytopenia
- Paradoxical pulse
- Water retention
- Raynaud's syndrome
- Heart murmur
- Drowsiness
- Sweating
- Night sweats
- Fainting
- Tachycardia
- tachypnoea
- Cardiac tamponade
- Cough
- Pericardial effusion
- Dizziness
Further indications
The symptoms depend on the type, the location and the size of the tumor, and the degree of involvement of the cardiac structures. Some cardiac tumors at onset are asymptomatic or cause little specific manifestations, often interpreted as signs of other more common and less serious cardiovascular diseases.
Over time, the manifestations of benign primary cardiac tumors may depend on the compression of the cardiac chambers or coronaries, irritation of the pericardium, obstructed flow through the valves and embolization of small tumor fragments. Pericardial involvement can lead to chest pains, an irritated cough, shortness of breath and angina, and, if a effusion is present, cardiac tamponade can occur. If the tumor prevents the valvular function and / or the outflow can cause stenosis or dysfunction of the heart valves and compromise the activity of the heart. The involvement of the conduction system, on the other hand, can cause palpitations, systolic mitral murmur, tachycardia and atrioventricular or intraventricular block.
Systemic symptoms caused by cardiac tumors include fever, chills, sleepiness, arthralgia, muscle weakness, difficulty swallowing, peripheral edema and general decay, with weight loss and skin pallor. Sometimes, hemoptysis, fainting, petechiae, Raynaud's syndrome and digital hippocratism are present. The picture can be complicated with pulmonary edema, respiratory failure, embolism (pulmonary, cerebral or peripheral) and myocardial infarction.
The symptoms of malignant cardiac tumors have an acute onset and a more rapid progression; arrhythmias, fever, malaise, weight loss, night sweats, anorexia, pericarditis and progressive heart failure may occur. Metastatic cardiac tumors, on the other hand, can manifest as sudden cardiac dilatation, tamponade, cardiac arrest or acute heart failure.
The diagnostic evaluation uses echocardiography and imaging techniques (chest radiography, computed tomography and magnetic resonance). The presence of a cardiac tumor is confirmed by echocardiography and tissue typing by biopsy (during catheterization or open thoracotomy).
Treatment of benign tumors usually involves surgical resection. The treatment of malignant or metastatic neoplasms depends on the type and origin of the tumor: it can include radiotherapy, systemic chemotherapy and management of complications.
