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  • Review Article
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Pathology, imaging, and treatment of cardiac tumours

Nature Reviews Cardiology volume 14, pages 536–549 (2017)Cite this article

Subjects

Key Points

  • Cardiac tumours (or masses) are rare, abnormal growths in the heart or heart valves that can be malignant or benign

  • Increasing awareness of the presenting and radiological features of cardiac growths, together with high-sensitivity diagnostic imaging modalities have improved recognition of these lesions

  • Among cardiac neoplasms, metastasis is substantially more common than primary cardiac malignancies

  • A number of cardiac neoplasms are associated with syndromes (such as Carney complex) for which patients should be appropriately evaluated, for both follow-up and counselling on hereditary implications

  • Molecular genetic testing of primary cardiac malignancies is becoming routine with the advent of targeted pharmacotherapy

Abstract

Cardiac tumours are a rare, but often devastating, clinical diagnosis. They encompass a broad set of lesions that include both neoplastic and non-neoplastic conditions. Cardiac tumours are often diagnosed incidentally during work-up for other conditions, or during ultrasound, CT, or MRI scans for unusual or nonspecific symptoms. In the past decade, important changes have been made in the nomenclature and the recommendations for diagnosis of cardiac tumours, as highlighted by the WHO's 2015 revision of the classification of cardiac tumours. Moreover, important advances in molecular genetics and therapeutics offer new approaches for the diagnosis and treatment of affected patients. In this Review, we provide an overview of the clinical, pathological, and imaging characteristics of all types of cardiac masses, including both benign and malignant primary cardiac neoplasms.

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Figure 1: Mechanisms of metastatic growth in the heart.
Figure 2: Cardiac metastases.
Figure 3: Imaging characteristics of cardiac myxoma.
Figure 4: Gross and histopathological characteristics of cardiac myxoma.
Figure 5: Cardiac rhabdomyoma.
Figure 6: Cardiac fibroma.
Figure 7: Cardiac lipoma.
Figure 8: Cardiac angiosarcoma.
Figure 9: Macroscopic and imaging characteristics of papillary fibroelastomas.
Figure 10: Lipomatous hypertrophy of the atrial septum.
Figure 11: Atrial thrombus.
Figure 12: Cardiac gossypiboma.

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Authors and Affiliations

  1. Department of Laboratory Medicine & Pathology, Mayo Clinic, 200 First Street SW, Rochester, 55905, Minnesota, USA

    Joseph J. Maleszewski

  2. Department of Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, 55905, Minnesota, USA

    Joseph J. Maleszewski, Nandan S. Anavekar & Kyle W. Klarich

  3. Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, 55905, Minnesota, USA

    Nandan S. Anavekar

  4. Division of Medical Oncology, Mayo Clinic, 200 First Street SW, Rochester, 55905, Minnesota, USA

    Timothy J. Moynihan

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Maleszewski, J., Anavekar, N., Moynihan, T. et al. Pathology, imaging, and treatment of cardiac tumours. Nat Rev Cardiol 14, 536–549 (2017). https://doi.org/10.1038/nrcardio.2017.47

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