PRIMARY CARDIAC TUMORS - 40 YEARS EXPERIENCE WITH 71 PATIENTS

BACKGROUND, Primary cardiac tumors are infrequent, and few cardiac sur geons have extensive experience in treating them. The majority of the tumors are benign. As noninvasive diagnostic imaging of cardiac masses continues to improve, the number of these tumors that are seen by cli nicians will increase. More of the malignant tumors may be curable if detected at an earlier stage. METHODS, A retrospective review was cond ucted of all patients with primary cardiac tumors managed by a univers ity teaching center over a period of 40 years, using hospital medical records and a Provincial cardiovascular surgery database. RESULTS, Sev enty-one patients (25 males and 46 females) with primary cardiac tumor s were identified. Fifty-seven (80%) were benign masses and 14 (20%) w ere malignant masses. Twenty-eight percent of the tumors in men were m alignant (7 of 25) compared with only 15% in women (7 of 46). Seventy- two percent of the masses were located in the left atrium. Forty-three percent of tumors in the right atrium were malignant (6 of 14) compar ed with only 14% in the left atrium (7 of 51). Complete resection was possible for 50 of 52 benign atrial tumors (96%) but for only 5 of 14 malignant tumors (36%). There was one perioperative death (1.4%). Thre e patients had no surgery because of their poor medical condition. Two of the patients with unresectable malignant tumors were still alive a t last follow-up. The remaining 12 patients with malignancy have all d ied of their disease. CONCLUSIONS, Primary cardiac tumors are uncommon . Most patients present with symptoms of congestive heart failure. The second most common presenting symptom is embolization. Improvement in noninvasive diagnostic technology has increased the number of patient s identified with a primary cardiac tumor and has also increased the n umber referred for surgical resection. The majority of left atrial tum ors were benign, whereas up to one-half of tumors found in the right a trium were malignant. A greater proportion of malignant primary tumors were found in men than in women. Malignant cardiac tumors tend to be diagnosed after they have become extensive and the patients already ha ve a very grave prognosis. (C) 1997 American Cancer Society.