Sudden death due to primary atrial neoplasms: Report of two cases and review of literature

Primary cardiac tumours are very uncommon lesions with an estimated incidence of less than 0.03% during autoptic examination. Among these, about 75% are benign, mainly myxomas. The intracardiac tumours occur over a wide range of ages and can progress silently or have many clinical presentations, such as valvular dysfunction, cardiac compression and embolic accidents, mostly in case of atrial localization. Primary atrial tumours often progress asymptomatically. Sudden death could represent the “first symptom” of these pathological findings. Indeed, cardiac neoplasms may cause disorders of atrioventricular or intraventricular conduction, which are manifested by fatal arrhythmias. Two cases of sudden death due to atrial tumours are reported. A complete autoptic examination, with histologic and immunohistochemical study of cardiac lesions, confirmed that these neoplasms were primary. Very few cases of sudden death due to right atrial tumours have been described in forensic literature, a fact which emphasizes their rarity.