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Overview of Heart Tumors

By

Anupama K. Rao

, MD, Rush University Medical Center

Last full review/revision Feb 2021| Content last modified Feb 2021
Click here for the Professional Version
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A tumor is any type of abnormal growth, whether cancerous (malignant) or noncancerous (benign). Tumors in the heart may be

  • Primary (noncancerous or cancerous)

  • Metastatic (always cancerous)

Primary heart tumors are tumors that originate in the heart. Primary heart tumors are rare, occurring in fewer than 1 of 2,000 people. Most primary heart tumors are noncancerous.

Metastatic heart tumors are cancers that developed in another organ and then spread to the heart. Most heart tumors are metastatic cancer, and most are cancers that spread from the lungs.

Did You Know...

  • Noncancerous (benign) tumors can be as deadly as cancerous ones if they interfere with the heart's function.

Both primary and metastatic tumors may develop in the tissue lining the inside of chambers of the heart (endocardium), the heart muscle (myocardium), the heart valves, or in the sac that surrounds the heart (pericardium). Tumors in the endocardium and heart valves can block blood flow through the heart or cause blood clots that can break off and go to other parts of the body (embolism). Tumors in the myocardium can affect heart function and lead to heart failure Heart Failure (HF) Heart failure is a disorder in which the heart is unable to keep up with the demands of the body, leading to reduced blood flow, back-up (congestion) of blood in the veins and lungs, and/or... read more Heart Failure (HF) or affect the heart's electrical conduction system and cause abnormal heart rhythms Overview of Abnormal Heart Rhythms Abnormal heart rhythms (arrhythmias) are sequences of heartbeats that are irregular, too fast, too slow, or conducted via an abnormal electrical pathway through the heart. Heart disorders are... read more Overview of Abnormal Heart Rhythms . Tumors in the pericardium may squeeze (constrict) the heart, preventing it from filling properly. Chest pain and heart failure Heart Failure (HF) Heart failure is a disorder in which the heart is unable to keep up with the demands of the body, leading to reduced blood flow, back-up (congestion) of blood in the veins and lungs, and/or... read more Heart Failure (HF) may develop.

Noncancerous primary heart tumors

In adults, about half of noncancerous primary heart tumors are myxomas Myxomas A myxoma is a noncancerous primary heart tumor, usually irregular in shape and jellylike in consistency. People may feel short of breath or faint, or they may have fever or weight loss. Doctors... read more . Myxomas usually develop in the heart's left upper chamber (atrium). They may develop from embryonic cells located in the inner layer (lining) of the heart's wall.

In infants and children, the most common type of noncancerous primary heart tumor is a rhabdomyoma. Rhabdomyomas, which typically occur in groups, usually grow within the heart wall and develop directly from the heart's muscle cells. Rhabdomyomas commonly develop during infancy or childhood, often as part of a rare disease called tuberous sclerosis Tuberous Sclerosis Complex Tuberous sclerosis complex is a hereditary disorder that causes abnormal growths in the brain, changes in the skin, and sometimes tumors in vital organs, such as the heart, kidneys, and lungs... read more Tuberous Sclerosis Complex .

Another common noncancerous primary tumors in infants and children are fibromas. Fibromas, which typically occur as a single tumor, usually grow within the heart muscle and develop from the heart's fibrous tissue cells.

Several other types of primary heart tumors can develop, but all are rare. Some are cancerous and some benign.

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Cancerous primary heart tumors

Cancerous primary heart tumors include

  • Sarcoma

  • Mesothelioma

  • Lymphoma

Sarcomas are cancers that develop from connective tissues (blood vessels, nerves, bones, fat, muscles, and cartilage). Sarcomas develop in the right or left atrium and can block blood flow through the heart. Tumors in the right atrium can spread to the lungs.

Mesothelioma Mesothelioma Mesothelioma is cancer of the thin, transparent, two-layered membrane that covers and lines the inside of the chest wall and abdomen. The most common symptoms are persistent chest pain and shortness... read more is a rare cancer that can develop in the membrane that covers the heart (pericardium), although it most often develops in the membrane that covers the lungs (pleura). Pericardial mesothelioma can spread to the spine and brain.

Lymphoma Overview of Lymphoma Lymphomas are cancers of lymphocytes, which reside in the lymphatic system and in blood-forming organs. Lymphomas are cancers of a specific type of white blood cells known as lymphocytes. These... read more Overview of Lymphoma is a cancer of white blood cells known as lymphocytes. Lymphoma usually develops in the lymph nodes, spleen, and/or bone marrow. Lymphoma that develops in the heart is extremely rare. It usually occurs in people who have AIDS and grows rapidly.

Metastatic heart tumors

Symptoms of Heart Tumors

Heart tumors may cause no symptoms, minor symptoms, or symptoms of life-threatening heart malfunction.

Noncancerous tumors can be as deadly as cancerous ones if they interfere with the function of the heart.

Major symptoms of heart tumors include

Other symptoms may include

  • Fever

  • Fatigue (lethargy)

  • Joint pain

  • Small red spots on the skin (petechiae)

Heart murmurs The medical history and physical examination can suggest that a person has a heart or blood vessel disorder that requires additional testing for accurate diagnosis. When doctors "take a medical... read more (sounds caused by turbulent blood flow through the heart) develop in about half of the people who have tumors that develop near or on a heart valve (such as myxomas and fibromas) because blood does not flow through the valve normally. Heart tumors that block the valves, compress the heart, or affect the muscular wall of the heart can lead to heart failure, causing shortness of breath and swelling of the legs. Those affecting the electrical system in the heart can cause abnormal heart rhythms, causing palpitations or fainting. If blood flow through the heart is decreased by a tumor blocking the valves or by a tumor in the pericardium compressing the heart, people may develop low blood pressure Low Blood Pressure Low blood pressure is blood pressure low enough to cause symptoms such as dizziness and fainting. Very low blood pressure can cause damage to organs, a process called shock. Various drugs and... read more , leading to dizziness and fainting.

Heart tumors, especially myxomas Myxomas A myxoma is a noncancerous primary heart tumor, usually irregular in shape and jellylike in consistency. People may feel short of breath or faint, or they may have fever or weight loss. Doctors... read more and sometimes fibroelastomas, may degenerate so that pieces of them break off and travel through the bloodstream (becoming emboli). Emboli may lodge in small arteries and block blood flow. Also, blood clots that form on the surface of tumors, such as myxomas, may break off as emboli and block arteries. Symptoms due to emboli depend on where the material goes and therefore which tissues or organs are affected by the blocked artery. For example, emboli that block an artery in the brain can cause a stroke Overview of Stroke A stroke occurs when an artery to the brain becomes blocked or ruptures, resulting in death of an area of brain tissue due to loss of its blood supply (cerebral infarction) and symptoms that... read more .

Diagnosis of Heart Tumors

  • Imaging with echocardiography, computed tomography (CT), and/or magnetic resonance imaging (MRI)

Primary heart tumors are difficult to diagnose because they are relatively uncommon and because their symptoms resemble those of many other disorders. Doctors may suspect a primary heart tumor in people who have heart murmurs, abnormal heart rhythms Overview of Abnormal Heart Rhythms Abnormal heart rhythms (arrhythmias) are sequences of heartbeats that are irregular, too fast, too slow, or conducted via an abnormal electrical pathway through the heart. Heart disorders are... read more Overview of Abnormal Heart Rhythms (causing palpitations, weakness, or fainting), unexplained symptoms of heart failure Heart Failure (HF) Heart failure is a disorder in which the heart is unable to keep up with the demands of the body, leading to reduced blood flow, back-up (congestion) of blood in the veins and lungs, and/or... read more Heart Failure (HF) (causing shortness of breath, swelling of the legs, and fatigue), or unexplained fever (which may be due to a myxoma). Metastatic heart tumors are suspected when people who have cancer elsewhere in the body come to a doctor with symptoms of heart malfunction. More often, heart tumors are diagnosed when a person is undergoing testing for another medical condition, such as for difficulty breathing.

If a tumor is suspected, echocardiography Echocardiography and Other Ultrasound Procedures Ultrasonography uses high-frequency (ultrasound) waves bounced off internal structures to produce a moving image. It uses no x-rays. Ultrasonography of the heart (echocardiography) is one of... read more Echocardiography and Other Ultrasound Procedures is usually done to confirm the diagnosis. For this procedure, a probe that emits ultrasound waves is passed over the chest, producing an image of heart structures. If another view of the heart is needed, the probe can be passed down the throat into the esophagus to record signals from just behind the heart. This procedure is called transesophageal echocardiography Ultrasonography uses high-frequency (ultrasound) waves bounced off internal structures to produce a moving image. It uses no x-rays. Ultrasonography of the heart (echocardiography) is one of... read more .

Unlike with tumors in most other parts of the body, doctors rarely do a heart biopsy (taking a tissue sample to look at it under a microscope). Heart biopsy may be dangerous depending upon the location of the tumor, and doctors can usually tell the difference between benign and cancerous heart tumors from the results of imaging tests.

Treatment of Heart Tumors

  • Surgical removal of noncancerous (benign) heart tumors

  • Sometimes chemotherapy or radiation for people with cancerous heart tumors

Noncancerous (benign) heart tumors

A single small noncancerous primary heart tumor can be surgically removed, usually resulting in a cure. If a large noncancerous primary tumor is significantly reducing blood flow through the heart, removal of the part of the tumor that does not grow into the heart wall may improve heart function. However, if a large part of the heart wall is involved, surgery may be impossible.

Rhabdomyomas regress without treatment in most affected newborns and usually do not require treatment.

In infants and children, a fibroma that does not affect the wall between the ventricles (septum) may be successfully removed. Tumors that affect this wall usually also affect the electrical conduction system of the heart Tracing the Heart’s Electrical Pathway Abnormal heart rhythms (arrhythmias) are sequences of heartbeats that are irregular, too fast, too slow, or conducted via an abnormal electrical pathway through the heart. Heart disorders are... read more Tracing the Heart’s Electrical Pathway and cannot be surgically removed. Children with this type of tumor usually die of an abnormal heart rhythm at an early age. If a fibroma is large, blocks blood flow, and has grown into the surrounding tissue, heart transplantation Heart Transplantation Heart transplantation is the removal of a healthy heart from a recently deceased person and then its transfer into the body of a person who has a severe heart disorder that can no longer be... read more may be required.

Transplantation is very rarely done in either children or adults, and only people with noncancerous tumors are typically considered for heart transplantation.

Cancerous heart tumors

Primary cancerous tumors cannot be surgically removed and are usually fatal. Chemotherapy or radiation therapy is sometimes used to slow progression of disease. Treatment of metastatic cancer depends on what organ the cancer came from and may include chemotherapy.

Pericardial tumors

Noncancerous tumors in the pericardium can be removed surgically, but cancerous tumors are not removed because they have usually already spread elsewhere in the body. If the tumor secretes fluid that interferes with heart motion, this fluid can be drained with a small plastic tube inserted by needle into the space between the pericardium and the heart (the pericardial space). Sometimes drugs are injected into the pericardial space to slow the tumor's growth or keep the fluid from building up again.

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