Diagnosis and treatment of cardiac tumors

Our plain-English summary of Diagnosis and treatment of cardiac tumors, by T. Imai, T. Shimoi, A. Kawai, et al (Medical Oncology, 2025).

The study

• Authors: T. Imai, T. Shimoi, A. Kawai, K. Yonemori
• Journal: Medical Oncology
• Published: 2025;42(4):110
• Type of article: Review
• Cited by: 15 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Cardiac tumors, though rare, present significant diagnostic and therapeutic challenges due to their diverse nature and potential severity. These tumors, which can be primary or metastatic, are often detected incidentally through imaging modalities such as echocardiography or CT scans. Differentiating between benign and malignant forms is crucial for guiding appropriate management strategies. This review synthesizes current diagnostic approaches and treatment modalities for cardiac tumors, with a focus on the role of imaging techniques like UCG, CT, MRI, and PET in tumor characterization. Multidisciplinary treatment plans are necessary, including surgical resection for benign tumors, chemotherapy, and radiotherapy for malignant tumors, and novel targeted therapies such as MDM2 inhibitors for selected cases. While primary malignant tumors like sarcomas and mesotheliomas exhibit rapid progression and poor prognosis, recent advances in multimodal therapy offer potential improvements in survival. The incidence of primary cardiac tumors is low, with an autopsy-reported occurrence rate of 0.02%. Benign cardiac tumors, such as myxomas and fibromas, generally have favorable outcomes with surgical resection. In contrast, primary malignant tumors like sarcomas and mesotheliomas exhibit rapid progression and poor prognosis, necessitating aggressive treatment including surgery, chemotherapy, and radiotherapy. Metastatic cardiac tumors occur in approximately 10% of cancer patients at autopsy and are managed according to the treatment plan for the primary malignancy. The management of cardiac tumors requires a multidisciplinary approach tailored to tumor type, location, and systemic effects. While benign tumors often respond well to surgical management, malignant and metastatic tumors demand more complex strategies to optimize patient outcomes.

© 2025. The Author(s).

In plain English

This article was a narrative review by authors at the National Cancer Center Hospital in Tokyo, Japan. It summarized earlier published studies on how tumors of the heart are diagnosed and treated. It reported no new patient data and did not discuss asbestos. Citing other studies, the authors wrote that primary heart tumors were found in about 0.02% of autopsies, that about 90% of them were benign, and that about 10% of cancer patients had cancer spread to the heart or pericardium at autopsy. Among malignant primary heart tumors, they gave sarcomas as 64.8%, lymphomas as 27% and mesotheliomas as 8%. They described primary pericardial mesothelioma as extremely rare, at 0.8% of all mesotheliomas, with no established standard treatment and an average survival of about 4 to 6 months. They wrote that malignant pleural mesothelioma and malignant melanoma have the highest tendency to spread to the heart. The authors concluded that the outlook for malignant heart tumors that cannot be removed remains poor, but that advances in combined treatments, including targeted therapies, hold promise.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: narrative review of published literature (no new data)
• Who was studied: Published studies on primary and metastatic cardiac tumors in children and adults. No search method or number of studies is stated. The authors were at the National Cancer Center Hospital, Tokyo, Japan.
• Main results:
  • Citing autopsy series from other studies, primary cardiac tumors occurred in about 0.02% of autopsies, around 200 tumors per 1 million autopsies.
  • Citing other studies, about 10% of cancer patients had metastasis to the heart or pericardium at autopsy, making metastatic cardiac tumors 20 to 40 times more common than primary ones.
  • Among malignant primary cardiac tumors, the review gave sarcomas as 64.8%, lymphomas as 27% and mesotheliomas as 8%.
  • Citing other studies, primary pericardial mesothelioma accounted for 0.8% of all mesotheliomas and 2% to 3% of all pericardial tumors.
  • For primary pericardial mesothelioma, the review reported an average survival time of approximately 4 to 6 months, citing another study.
  • The review stated that malignant pleural mesothelioma and malignant melanoma have the highest propensity to metastasize to the heart, citing another study.
• The authors' conclusion: The authors concluded that the prognosis of malignant cardiac tumors that cannot be resected remains poor, but that advances in multimodal therapy, including targeted therapies, hold promise. They also concluded that metastatic tumors are generally treated according to the plan for the primary cancer.
• Limitations the authors state:
  • The authors noted that the literature on treating cardiac sarcomas is limited to case reports and single-institution studies, with no standardized treatment protocol.
  • For primary pericardial mesothelioma, the authors stated that there is no established standard treatment and that the effectiveness of chemotherapy is not clearly established.

Topics

Medical terms in this study, explained in our Lexicon: CT Scan, Surgical Resection, Chemotherapy, Sarcoma, Mesothelioma, Prognosis, Multimodal Therapy, Autopsy.

Related studies

• Surgical pathology of primary cardiac and pericardial tumors — C. Basso, M. Valente, et al. (1997)
• Primary cardiac tumors: experience at the University of Minnesota — J.E. Molina, J.E. Edwards, et al. (1990)
• Malignant primary cardiac tumors. The Cleveland Clinic experience, 1956 to 1986 — P.A. Bear, D.S. Moodie (1987)
• Cardiac tumors that cause arrhythmias — K.F. Kusano, T. Ohe (2002)
• Cardiac masses: assessment by MR imaging — J.T. Lund, R.L. Ehman, et al. (1989)
• Trends in cardiac metastasis — B. Karwinski, E. Svendsen (1989)

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