Mary L. Grebenc, LCDR, MC, USNR ; Melissa L. Rosado de Christenson, Col USAF, MC ; Allen P. Burke, MD ; Curtis E. Green, MD ; Jeffrey R. Galvin, MD
1 From the Department of Radiology, National Naval Medical Center, Bethesda, Md (M.L.G.); the Departments of Radiologic Pathology (M.L.R., J.R.G.) and Cardiovascular Pathology (A.P.B.), Armed Forces Institute of Pathology, Bldg 54, Rm M-121, 14th and Alaska Sts, NW, Washington, DC 20306-6000; and the Department of Radiology, Georgetown University Hospital, Washington, DC (C.E.G.). Received March 28, 2000; revision requested April 10 and received April 24; accepted April 24.
Primary cardiac and pericardial neoplasms are rare lesions and include both benign and malignant histologic types. Myxoma is the most frequent primary cardiac neoplasm, but other benign tumors include papillary fibroelastoma, rhabdomyoma, fibroma, hemangioma, lipoma, and paraganglioma. Cardiac sarcoma represents the second most common primary cardiac neoplasm. Lymphoma can also affect the heart primarily. Pericardial tumors that affect the heart include benign teratomas and malignant mesotheliomas. Patients affected with cardiac or pericardial neoplasms often present with cardiovascular compromise or embolic phenomena and exhibit cardiomegaly at chest radiography. Benign cardiac tumors typically manifest as intracavitary, mural, or epicardial focal masses, whereas malignant tumors demonstrate invasive features and may involve the heart diffusely. Benign lesions can usually be successfully excised, but patients with malignant lesions have an extremely poor prognosis.