[Malignant cardiac tumors].
Cardiac neoplasms are a rare occurrence in clinical practice. The various frequencies of primary and secondary malignant tumors vary from report to report, approximately 1% in most autopsy series and 4% in cancer patient's autopsies. Cardiac malignancies account for less 1% of cardiac surgery and about for 0.1% of cardiac echographic studies. The presence of metastatic tumor to the heart usually indicates widespread metastases. Lung carcinomas are the most commonly encountered tumor followed by breast and pancreas cancer and melanoma. Apart from primary pericardial mesothelioma, primary cardiac tumors are high-grade sarcomas with a high metastatic potency that often becomes evident early after surgery. Symptoms are non specific, occur late in the disease and affect few patients; especially secondary neoplasms of the heart take their course so fast that they cannot become symptomatic. The signs of cardiac neoplasms are divided into systemic symptoms (fever, arthralgias and myalgias), cardiac symptoms (congestive heart failure, arrhythmia, chest pain) and uncommon embolisms. Diagnosis is actually made easier with cardiac echography. Cardiac RMI is helpful to estimate vessels and pericardium involvement. Due to its poor prognosis, treatment of cardiac metastases is restricted to best supportive care. For primary cardiac neoplasms, surgery must be carefully discussed because operative intervention is often followed by rapid widespread metastases that adjuvant chemotherapy cannot avoid in most cases.
Debourdeau
Philippe
P
Service de Médecine Interne, Hôpital Desgenettes, 108, boulevard Pinel, 69003 Lyon. philippe.debourdeau@9oneline.fr
Gligorov
Joseph
J
Teixeira
Luis
L
Aletti
Marc
M
Zammit
Christine
C
D006338:Heart Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D006801:Humans; D011379:Prognosis