Cardiac Tumor

Cardiac tumors, also called heart tumors, are growths that form in your heart. They can be either cancerous (malignant) or noncancerous (benign). Heart tumors vary in size from less than half an inch to about 6 inches. How the tumor affects you depends on its type, size and location in your heart. Some heart tumors are easily treatable and have an excellent prognosis. Others can be fatal.

Heart tumors can affect anyone at any age. Some types are present at birth. Others develop during childhood or adulthood. They can form in many different areas of your heart, including its inner lining (endocardium), muscle (myocardium), protective sac (pericardium) or valves.

Overall, cardiac tumors are rare. Experts estimate they affect between 1 and 30 in every 100,000 people.

Types of heart tumors

Heart tumors fall into two main groups:

• Primary heart tumors: These start in your heart. Most (about 85%) are noncancerous, but some (about 15%) are cancerous. Even noncancerous tumors can be dangerous if they interfere with your heart function, and they can pose a risk of a stroke if left untreated.
• Metastatic heart tumors: These start somewhere else in your body and spread to your heart. They’re always cancerous. Up to 1 in 10 people with a cancer diagnosis have tumors that spread to their heart.

Noncancerous primary heart tumors

Tumors that start in your heart and aren’t cancerous include:

• Papillary fibroelastoma (PFE): This is the most common benign primary heart tumor that affects adults. It usually develops on the aortic valve or mitral valve. 
• Cardiac myxoma: This is the next most common type among adults. It most often forms in the left atrium. 
• Cardiac rhabdomyoma: This is the most common type of heart tumor in infants and children. Rhabdomyomas grow in clusters. They usually go away on their own.
• Cardiac fibroma: This is the next most common type among kids. Fibromas usually form in the wall that separates the lower two heart chambers. Experts have found links between these tumors and gene changes, including those that occur in Gorlin syndrome.
• Adult cellular rhabdomyoma: This is a rare tumor that only affects adults. It can form in many different areas of the heart. Usually, surgery can successfully remove it.
• Lipomatous hypertrophy of the atrial septum: This is a collection of fat and heart muscle cells. It forms on the wall between your top two heart chambers (atrial septum). The growth makes the septum thicker than normal. It’s often discovered by accident on imaging tests.
• Cardiac lipoma: This type tends to form on the heart’s outermost layer (epicardium). It usually doesn’t cause symptoms. But it can sometimes cause chest pain, fainting or life-threatening abnormal heartbeats. Surgery can remove the tumor.
• Cardiac hemangioma: This type is rare but can affect people at any age. Most people diagnosed are in their 40s. The tumor may have no symptoms or cause shortness of breath, fainting or chest pain. Surgery is usually possible and successful.
• Cystic tumor of the AV node: This type is present at birth. It forms near a cluster of cells that help control your heartbeat, called the AV node. It’s often very small (one-tenth of an inch). But it’s serious because it can lead to sudden death.

Cancerous primary heart tumors

Cancerous tumors that start in your heart include:

• Sarcomas: There are several types of sarcoma that can develop in your heart. The most common ones are cardiac angiosarcoma, cardiac undifferentiated pleomorphic sarcoma and cardiac leiomyosarcoma. They usually affect people between ages 30 and 50.
• Lymphomas: It’s rare for lymphoma to first form in the heart. When it does, diffuse large B-cell lymphoma is the most common type. It most often affects males in their 50s and 60s.

Metastatic heart tumors

These are 20 to 30 times more common than primary heart tumors. But they’re still rare overall. Many different types of cancer can spread to your heart. Examples include:

• Breast cancer
• Kidney cancer
• Lung cancer
• Lymphoma
• Melanoma
• Pleural mesothelioma
• Stomach cancer

Symptoms of heart tumors

Cardiac tumor symptoms vary based on its type and exact location in your heart. Some people have no symptoms or very mild ones. Others have symptoms that signal life-threatening heart problems. In general, people with cancerous heart tumors have symptoms that begin suddenly and get worse quickly. Symptoms of noncancerous heart tumors may develop more gradually.

You may experience:

• Chest pain or discomfort
• Fainting or feeling like you might faint
• Fatigue or a general sense of not feeling well
• Fever
• Heart palpitations
• Low blood pressure
• Joint pain or stiffness
• Muscle aches
• Shortness of breath
• Swelling in your legs or feet
• Weight loss without a known cause

Many of these symptoms are “non-specific.” That means many different medical conditions could cause them, besides heart tumors. It’s important to tell your healthcare provider about what you’re feeling so they can look for the cause.

Cardiac tumor causes

It’s not always clear what causes primary heart tumors. Genetic syndromes, like Carney complex, may play a role in causing some noncancerous ones.

Metastatic heart tumors are linked to more advanced cancers. They develop when cancer spreads from another part of your body to your heart.

Complications of this condition

Heart tumors of any type can keep your heart from working like it should. For example, tumors that grow on your heart valves can disrupt normal blood flow in your heart. Tumors in your heart muscle may keep electrical signals from traveling normally through your heart. Possible complications include:

• Embolism
• Heart attack
• Heart failure
• Stroke or transient ischemic attack (TIA)
• Sudden cardiac death
• Arrhythmias

How doctors diagnose this condition

Your healthcare provider will perform a physical exam and talk with you about any symptoms you have. Based on what they find, they may run some tests. Testing can show a tumor’s size, location and whether it might be cancerous.

You may need one or more of the following tests:

• Transthoracic echocardiogram: Can show tumors in your lower heart chambers
• Transesophageal echocardiogram: Can show tumors in your upper chambers
• Cardiac MRI: Helps identify details about the tumor, like whether it’s cancerous
• Cardiac CT scans: Evaluates your entire chest area (including your lungs and blood vessels) and your coronary arteries
• PET scan: Can show if cancer in another part of your body has spread to your heart
• Heart biopsy: Removes a tiny tissue sample from your heart to check for cancer

If you have cancer somewhere else in your body along with sudden heart problems, your provider may suspect a heart tumor. Testing can show if the cancer has spread to your heart.

Primary heart tumors are often hard to diagnose. They share symptoms with many other health conditions. Your provider may suspect a primary tumor if you have symptoms of heart failure without a clear cause. But usually, providers diagnose these tumors when they’re not looking for them. An imaging test done for another reason may show a tumor and lead to further testing. 

How are cardiac tumors treated?

Treatment depends on the type of tumor you have and how it affects your body. Your healthcare provider will explain what’s best in your case. Possible treatments include:

• Heart tumor removal surgery: This is a first-line treatment for many noncancerous primary heart tumors. Removing the tumor lets your heart function normally and protects you from complications. Surgery may be an option for some cancerous heart tumors.
• Chemotherapy: This is a common treatment for cancerous heart tumors. You receive medicine that destroys cancer cells. This can help shrink the tumors and relieve symptoms.
• Radiation therapy: This treatment uses high-powered X-rays to destroy cancer cells. But because radiation may harm your heart, providers only use it in certain situations. For example, it may relieve symptoms when surgery isn’t an option.
• Expectant management: Sometimes the risk of treating the tumor is higher than the benefit of removing it. You provider may elect to monitor the tumor with serial images rather than immediately trying to remove/treat it.
• Palliative care: This provides symptom relief and support. It may help when other treatments aren’t possible or haven’t worked.

When should I see a healthcare provider?

If you’ve been diagnosed with a cardiac tumor, it’s important to follow your provider’s guidance. They’ll tell you how often to come in for appointments and what your treatment plan will involve. They may also recommend genetic testing for you and for your family members.

If you’ve had surgery to remove a tumor, you’ll need regular follow-ups and imaging tests. These tests allow your provider to check if any tumors have returned. They also allow your provider to check your heart function and treat any issues that come up.

If your child is diagnosed with a cardiac tumor, their provider will explain next steps. Your child may need treatment right away.

What can I expect if I have a heart tumor?

Your outlook depends on the type of tumor you have and how early it’s diagnosed. Overall, an earlier diagnosis leads to a better outcome. But some cancerous tumors spread aggressively and are difficult or impossible to cure. In general:

• Noncancerous primary heart tumors can often be removed successfully through surgery.
• Cancerous primary heart tumors are often fatal. These tumors spread quickly or come back after treatment. Your outlook depends on the tumor size, how much it’s spread and how early the cancer has been diagnosed.
• Metastatic heart tumors are usually fatal. People with these tumors face poor long-term outcomes due to the cancer’s aggressive spread.

You may find survival stats online for various types of cardiac tumors. But it’s important not to focus too much on these numbers. It’s hard to know if the numbers apply to you or what other factors affected them. Your provider is the best source of information on what you can expect in your unique situation.