Heart tumors in children and adults: clinicopathological study of 59 patients from a surgical center

BackgroundHeart tumors are rare lesions with variegated histological types. Their clinicopathological features could be more comprehensively categorized.MethodsThis is a 19-year retrospective study of 17 infants/toddlers (<2 years of age) and 42 patients aged between 14 and 79 years (mean=51.5) in a surgical center.ResultsCongenital tumors (n=17; 29%), including rhabdomyomas (n=9), ventricular fibromas (n=6), and hemangiomas (n=1), required surgery mainly because of mass effect. Familial myofibromatosis was the only embolic congenital lesion. Acquired benign tumors (n=28; 47%) included myxomas (n=21), fibroelastomas (n=3), myofibroblastic inflammatory tumors (n=2), and lipomas (n=2). Eight (29%) were revealed by systemic embolization. These benign noncongenital tumors were all treated by complete resection, except for an incompletely resected lipoma of the mitral valve. Postoperative arrhythmia (n=1) and pericardial effusion (n=3) were the only complications. Primary sarcomas (n=8; 14%) were mostly vascular tumors (five of eight), and patients with high-grade tumors had a mean survival of 15 months (n=5). Cardiac metastases (n=6; 10%) were from carcinomas (n=3) or sarcomas (n=3); apart from a necrotic metastasis, all patients died (mean survival of 6 months).ConclusionsThis study shows that, regardless of patients' age, heart tumors can be classified as: (a) congenital lesions, which are spontaneously nonprogressive or regressive lesions possibly requiring surgery mainly because of mass effect; (b) acquired benign tumors, which are lesions requiring surgery often because of embolization risk; and (c) primary and secondary malignant tumors, which are lesions with globally poor prognosis but with some indications for resection.