Heart tumors in children and adults: clinicopathological study of 59 patients from a surgical center.
BACKGROUND
Heart tumors are rare lesions with variegated histological types. Their clinicopathological features could be more comprehensively categorized.


METHODS
This 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.


RESULTS
Congenital 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).


CONCLUSIONS
This 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.
Thomas-de-Montpréville
Vincent
V
Department of Pathology, Marie Lannelongue Surgical Center, 92350 Le Plessis Robinson, France. de-montpreville@ccml.com
Nottin
Rémi
R
Dulmet
Elisabeth
E
Serraf
Alain
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D004452:Echocardiography; D005260:Female; D005350:Fibroma / Q000151:congenital / Q000473:pathology* / Q000601:surgery; D006338:Heart Neoplasms / Q000151:congenital / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009232:Myxoma / Q000473:pathology* / Q000601:surgery; D009362:Neoplasm Metastasis; D009365:Neoplasm Regression, Spontaneous; D012189:Retrospective Studies; D012207:Rhabdomyoma / Q000151:congenital / Q000473:pathology* / Q000601:surgery; D012208:Rhabdomyosarcoma / Q000151:congenital / Q000473:pathology*; D012509:Sarcoma / Q000151:congenital / Q000473:pathology* / Q000601:surgery