0521779407-C01 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 20:53
282 Cardiac Tumors
recurrences rare, occurring within 4 years of surgery
followup echo recommended
➣Rhabdomyoma
most common benign cardiac tumor of childhood – most
younger than 1 year of age
associated with tuberous sclerosis
usually located in multiple areas of ventricular myocardium;
can cause hypoxic episodes, syncope, heart failure, or arryth-
mias
surgical removal usually successful
➣Papillary fibroelastoma
resembles sea anemone
most frequently located on aortic or cardiac valves
up to 30% have systemic embolization
treat with anticoagulation
surgery reserved for patients with recurrent embolization
➣Fibromas (located near septal myocardium) and lipomas (occur
in both myocardium and pericardium)
size up to several centimeters
symptoms related to local tissue encroachment rather than
obstruction
■Malignant:
➣Angiosarcoma
most common malignant primary cardiac neoplasm
2–3×more frequent in men
ages 20–50
most from right atrium or pericardium with resultant signs/
symptoms of right–sided heart failure
hemorrhagic pericardial effusion or obliteration of pericardial
space by tumor cells and thrombus occurs
intracavitary mass effects and local metastases are common
precordial chest pain similar to pericarditis
poor prognosis – mean survival under 1 year after diagnosis
surgical therapy usually not possible secondary to extensive
disease at time of diagnosis
combined treatment with radiation and chemotherapy
➣Rhabdomyosarcoma
more common in men ages 20–50
can arise in any cardiac chamber; often multiple
poor prognosis – most die within 1 year of diagnosis