title: Primary cardiac tumors: 32 years of experience from a Spanish tertiary surgical center.
abstract: BACKGROUND
  Primary cardiac tumors are rare entities with an autopsy frequency ranging between 0.001% and 0.3%. Our objective was to review 32 years of experience from a Spanish tertiary surgical center.
  
  
  METHODS
  We collected data on 73 patients with a histopathological diagnosis of a primary cardiac tumor in a retrospective analysis from 1979 to 2012. Tissue samples were obtained either at surgery or from necropsy and subsequently divided into benign and malignant groups.
  
  
  RESULTS
  Benign neoplasms accounted for 84.9% of cases. The average age at diagnosis was 61 years, and tumors were twice as frequent among women. It was an incidental finding in one quarter of patients. In symptomatic patients, the typical presentation was of cardioembolic stroke or of congestive symptoms. Myxoma (93.5%) was the most common diagnosis, typically affecting the left atrium (74.2%). Surgical resection was curative for 95% of these patients. Malignant tumors represented 15.1% of cases with an average age at diagnosis of 50 years. Over 90% of these patients were symptomatic at presentation with the cardinal symptom being heart failure. Undifferentiated sarcoma was the most frequent malignant tumor (36.4%). Less than 20% of patients were alive 1 year after diagnosis despite the treatment.
  
  
  CONCLUSIONS
  In our study, primary cardiac tumors were insidious. The most common was left atrial myxoma in which surgical resection was considered curative. Undifferentiated sarcoma was the most frequent malignant tumor. Malignant neoplasms carried a worse prognosis with unsuccessful total excision and the presence of metastatic disease being markers of an adverse outcome.
authors.affiliation: Cardiology Department, Hospital Universitario Central de Asturias, Oviedo, Spain. Electronic address: manuelbarreiroperez@gmail.com.
authors.forename: Manuel
authors.initials: M
authors.lastname: Barreiro
authors.forename: Alfredo
authors.initials: A
authors.lastname: Renilla
authors.forename: Jaime M
authors.initials: JM
authors.lastname: Jimenez
authors.forename: María
authors.initials: M
authors.lastname: Martin
authors.forename: Tarique
authors.initials: T
authors.lastname: Al Musa
authors.forename: Laura
authors.initials: L
authors.lastname: Garcia
authors.forename: Vicente
authors.initials: V
authors.lastname: Barriales
mesh_terms: D000328:Adult; D000368:Aged; D058070:Asymptomatic Diseases; D006348:Cardiac Surgical Procedures; D005260:Female; D006338:Heart Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome
keywords: Cardiac pathology; Cardiac surgery; Cardiac tumors; Primary cardiac tumors