Heart Cancer


Heart cancer is an extremely rare form of cancer that is divided into primary tumors of the heart and secondary tumors of the heart.

Most heart tumors begin with myxomas, fibromas, rhabdomyomas, and hamartomas, although malignant sarcomas (such as angiosarcoma or cardiac sarcoma) have been known to occur. In a study of 12,487 autopsies performed in Hong Kong seven cardiac tumors were found, most of which were benign.[1] According to Mayo Clinic: “At Mayo Clinic, on average only one case of heart cancer is seen each year.”[1] In a study conducted in the Hospital of the Medical University of Vienna 113 primary cardiac tumour cases were identified in a time period of 15 years with 11 being malignant. The mean survival in the latter group of patients was found to be 26.2 ± 9.8 months.[2]

Primary malignant cardiac tumors (PMCTs) are even rarer. The most recent published study about PMCTs used the Surveillance, Epidemiology and End-Results (SEER) Cancer Registry to study 497 patients with PMCTs who were diagnosed during 2000-2001 in the United States. Most cases were angiosarcomas (27.3%) with an incidence of 0.107 per 1,000,000 person-years and Non- Hodgkin’s lymphomas [NHL] (26.9%), with an incidence of 0.108 per 1,000,000 person-years. The incidence rate of NHL increased significantly over the study period, but the incidence of cardiac angiosarcomas did not. The overall survival of NHL was found to be significantly better than angiosarcomas.[3]

Another previous study using the Surveillance, Epidemiology and End-Results (SEER) Cancer Registry from 1973–2011 found 551 cases of PMCTs, with an incidence of 34 cases per million persons. The study also found that the incidence has doubled over the past four decades. The associated mortality was very high, with only 46% of patients alive after one year. Sarcomas and mesotheliomas had the worst survival, while lymphomas had better survival. When compared with extracardiac tumors, PMCTs had worse survival.[4]

Secondary or metastatic heart tumours are much more common than primary heart tumours, occurring even 100 times more often[5]. Every tumour in theory can metastasise to the heart with the only exception being tumours of the central nervous system[6]. Malignant melanomas frequently metastasize to the heart, and represent the tumour with the highest rate of cardiac metastases (in more than half of cases)[7].

Patients with heart tumours usually have non-specific symptoms, such as dyspnea (in particular shortness of breath when lying down), thoracoabdominal pain, fatigue, hemoptysis, nausea and vomiting, fever, weight loss, and night sweats. These symptoms mimic symptoms of other heart diseases, which can make diagnosis difficult.

In most cases, the diagnosis is based on clinical history, echocardiography, a CT scan or an MRI scan. Cardiac tumours are often first diagnosed after the patient has had a stroke, an embolism caused by detached tumour tissue[8].

In most cases, patients with heart metastases have advanced tumour disease, with the heart being only one of the many places involved in the generalised tumour spread. At that stage of the disease, the patients will have already undergone extensive chemotherapy, radiation therapy or surgical procedures. Cardiac treatment is usually confined to palliative measures[9].

  1. ^ Jump up to: a b Moynihan TJ (2015-03-25). “Heart cancer: Is there such a thing?”. MayoClinic.com. Retrieved 2015-06-01.
  2. ^ Habertheuer A, Laufer G, Wiedemann D, Andreas M, Ehrlich M, Rath C, Kocher A (April 2015). “Primary cardiac tumors on the verge of oblivion: a European experience over 15 years”. Journal of Cardiothoracic Surgery. 10: 56. doi:10.1186/s13019-015-0255-4. PMC 4423145. PMID 25928192.
  3. ^ Saad AM, Abushouk AI, Al-Husseini MJ, Salahia S, Alrefai A, Afifi AM, Abdel-Daim MM (December 2017). “Characteristics, survival and incidence rates and trends of primary cardiac malignancies in the United States”. Cardiovascular Pathology. 33: 27–31. doi:10.1016/j.carpath.2017.12.001. PMID 29414429.
  4. ^ Oliveira GH, Al-Kindi SG, Hoimes C, Park SJ (December 2015). “Characteristics and Survival of Malignant Cardiac Tumors: A 40-Year Analysis of >500 Patients”. Circulation. 132 (25): 2395–402. doi:10.1161/CIRCULATIONAHA.115.016418. PMID 26467256.
  5. ^ Burke A, Virmani R. Tumors of the Cardiovascular System, Atlas of Tumour Pathology, 3rd Series, Fascicle 16. Washington, DC: Armed Forces Institute of Pathology 1996
  6. ^ Reynen, K. (2004-03-01). “Metastases to the heart”. Annals of Oncology. 15(3): 375–381. doi:10.1093/annonc/mdh086. ISSN 0923-7534.
  7. ^ “The heart in malignant melanoma: A study of 70 autopsy cases”. The American Journal of Cardiology. 21 (4): 555–571. 1968-04-01. doi:10.1016/0002-9149(68)90289-0. ISSN 0002-9149.
  8. ^ Hoffmeier A, Sindermann JR, Scheld HH, Martens S (March 2014). “Cardiac tumors–diagnosis and surgical treatment”. Deutsches Arzteblatt International. 111 (12): 205–11. doi:10.3238/arztebl.2014.0205. PMC 3983698. PMID 24717305.
  9. ^ Reynen, K. (2004-03-01). “Metastases to the heart”. Annals of Oncology. 15(3): 375–381. doi:10.1093/annonc/mdh086. ISSN 0923-7534.

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