Cardiac tumors are generally very rare, and not all require surgical treatment.

The most frequent tumors are metastases of cancer elsewhere in the body. They are 20 to 40 times more frequent than those originating in the heart. The most frequent are metastases of breast or lung cancer, followed by that of lymphomas, melanomas, and sarcomas.

Tumors that originate in the heart (called primaries) are even more uncommon. Of these, the majority (75%) are usually benign, being the most frequent myxoma. The most frequent are lipoma and papillary fibroblastoma. Other benign tumors include hamartoma, fibroids (which are more common in children), hemangioma, and teratoma.

The most common malignant primary tumors are sarcomas and lymphomas.

Most are usually asymptomatic from a cardiovascular point of view; The manifestations will depend on where in the heart they settle and the size of the tumor. Some may favor the formation of thrombi or even that part of the tumor separates and goes through the blood to other parts of the organism, producing an embolism.

When they affect the pericardium (which is a kind of bag that surrounds and protects the heart) can cause a pericardial effusion. They may also be responsible for cardiac arrhythmias, and even sudden death.

Benign tumors are usually found casually on the echocardiogram. The malignant tend to produce more general and nonspecific symptoms, such as fatigue, embolisms or alterations of the heart rhythm.

Regarding the treatment, we can summarize that the indication of surgery is reserved to the localized tumors, that is to say, that they are not extended to other organs. Certain cases of asymptomatic and small-sized benign tumors are sometimes not removed, and only follow-up is required with imaging tests; If they grow, they will have to be removed.

The tumor that most frequently requires surgery (because of its higher frequency) is the atrial myxoma. In the case of malignant tumors, in addition to surgical removal, radiotherapy and chemotherapy may be added to the treatment.

Surgery requires extracorporeal circulation and consists of completely resecting the mass to prevent recurrence. If the tumor affects a heart valve you can try to repair it, although it may need to be replaced by a prosthesis.

The prognosis of benign cardiac tumors is excellent, with a low risk of recurrence; However, the malignant have high mortality and usually reappear even if they are removed.

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