Cardiac Tumor

Overview

What are cardiac tumors?

Cardiac tumors (also called heart tumors) are growths that form in your heart. They can be either benign (noncancerous) or malignant (cancerous). Some are harmless or easily treatable, but others can be fatal. In general, an earlier diagnosis can lead to prompt treatment and better outcomes for people with cardiac tumors.

Cardiac tumors range in size and shape. Some are pedunculated, meaning they grow on a stalk. Heart tumors may be smaller than 1 centimeter in diameter or as big as 15 centimeters. Their size and location within your heart impact your symptoms and need for treatment.

What are the different types of cardiac tumors?

There are many types of cardiac tumors. Doctors classify them based on how they develop. Heart tumors that begin in your heart — rather than spreading from another part of your body to your heart — are called primary heart tumors. Primary heart tumors are usually noncancerous but are sometimes cancerous.

When cancer elsewhere in your body spreads to your heart, those tumors are called metastatic heart tumors. Metastatic heart tumors are always cancerous because they result from cancer that’s already in your body.

Noncancerous primary heart tumors

About 75% to 95% of all primary heart tumors are noncancerous. But they can still be dangerous if they interfere with your heart function, and can pose a risk of stroke if left untreated.

Noncancerous primary heart tumors that develop in adults include:

  • Myxoma. This is the most common noncancerous primary heart tumor (about 50% of all cases). It needs to be removed through surgery to prevent serious complications like an embolism. Myxomas usually develop in your left atrium.
  • Papillary fibroelastoma. This is the second most common noncancerous primary heart tumor. It can affect people at any age, but it’s usually diagnosed in people over age 60. About 80% of the time, this tumor grows on heart valves (usually your aortic or mitral valve). Even if you don’t have symptoms, your provider will recommend surgery to reduce your risk of an embolism.
  • Lipoma. This tumor affects people of many different ages. The tumor itself varies in its presentation. It may be small, or it may be very large. Lipomas usually develop in your left ventricle, right atrium or atrial septum (the wall that separates the top chambers of your heart).
  • Hemangioma. These tumors have been diagnosed across the lifespan, from infants to people 65 years old. They usually don’t cause symptoms. So, they’re often diagnosed through tests for other issues. Hemangiomas often occur along with tumors in your gastrointestinal tract or skin.

Noncancerous primary heart tumors that develop in infants and children include:

  • Cardiac rhabdomyoma. This is the most common type of heart tumor in infants and children. Rhabdomyomas grow in clusters and usually go away on their own without treatment.
  • Teratoma. This tumor typically develops on the pericardium (the sac that surrounds your child’s heart). It can also grow from the base of the major blood vessels connected to their heart.
  • Fibroma. Unlike a rhabdomyoma, a fibroma appears as a single tumor. It usually grows within the muscle of your child’s ventricles. Your child will likely need surgery to remove this tumor since it can cause serious heart problems.
  • Hamartoma. This tumor is also called histiocytoid cardiomyopathy or Purkinje cell hamartoma. It may affect your child’s heart rhythm.

Cancerous primary heart tumors

About 5% to 25% of all primary heart tumors are cancerous. Among those, the most common form is sarcoma.

Sarcoma affects 50% to 75% of people with heart cancer. Sarcoma has many subtypes. Two of the most common include:

  • Angiosarcoma. This is the most common subtype in adults. An angiosarcoma often develops in your right atrium or pericardium.
  • Rhabdomyosarcoma. This is the most common subtype in infants and children. But it can also affect adults. Rhabdomyosarcomas often form in groups and can develop in any heart chamber.

Less common forms of cancerous primary heart tumors include:

  • Malignant fibrous histiocytoma. This tumor often develops in your left atrium and may block your mitral valve, causing impaired blood flow in the chambers of your heart.
  • Lymphoma. Usually, lymphoma (a cancer of white blood cells) develops in your lymph nodes, spleen or bone marrow. Rarely, it develops in your heart. This usually happens in people who have AIDS.

Primary heart tumors that can be either noncancerous or cancerous

Some tumors that begin in your heart can be either noncancerous or cancerous. These include:

  • Mesothelioma. If this tumor develops in your pericardium, it’s cancerous. Rarely, though, it can begin in your atrioventricular node (part of your heart’s electrical system). In that case, it’s noncancerous.
  • Paraganglioma. This tumor usually develops at the base of your heart.

Metastatic heart tumors

Metastatic heart tumors are cancerous tumors that have spread to your heart from somewhere else in your body. Cancers that may spread to your heart include:

Where are cardiac tumors located?

Cardiac tumors can be located in many different parts of your heart. Both primary and metastatic heart tumors may form in the:

  • Endocardium, which is the tissue that lines your heart chambers.
  • Myocardium, which is your heart muscle.
  • Heart valves, which are the “doors” that manage blood flow through your heart.
  • Pericardium, which is the sac that surrounds your heart.

Who is affected by cardiac tumors?

Cardiac tumors can affect anyone at any age, depending on the form. Some forms (like teratomas) develop while a fetus is still in the uterus. Other forms develop during childhood or various stages of adulthood.

Myxomas are two to four times more common among people designated female at birth than in people designated male at birth.

Sarcomas are more common in middle-aged adults. The average age at diagnosis is 44.

How common are cardiac tumors?

Primary heart tumors (noncancerous and cancerous) affect fewer than 1 in 2,000 people. Of those, noncancerous tumors are much more common than cancerous ones.

Metastatic heart tumors are more common than primary heart tumors. They affect:

  • About 10% of people who have lung cancer.
  • About 10% of people who have breast cancer.
  • Between 50% and 65% of people who have melanoma.

How do heart tumors affect my body?

Heart tumors affect your body in many different ways. Cancerous heart tumors can spread elsewhere in your body, such as your lungs. Noncancerous heart tumors don’t spread but can cause heart and vascular problems, including:

How a tumor affects your heart depends on the tumor’s form and exactly where it’s located. For example, tumors that grow from your heart valves can interfere with blood flow in your heart or lead to blood clots. Tumors in your heart muscle may cause heart failure or arrhythmias.

If you’ve been diagnosed with a heart tumor, your provider will tell you where it’s located and how it may affect your heart.

Symptoms and Causes

What are the symptoms of a cardiac tumor?

The symptoms of cardiac heart tumors are all across the board. They vary based on the form of tumor you have and where it’s located in your heart. Some people have no symptoms or very mild symptoms. Others have symptoms that signal life-threatening heart problems.

Many cardiac tumor symptoms are what doctors call “non-specific.” That means lots of different health problems could trigger these symptoms, not just heart tumors. So, if you have these symptoms, it’s not always obvious you have a heart tumor. It’s important to tell your healthcare provider about your symptoms so they can look for the cause.

Generally, people with cancerous heart tumors have symptoms that begin suddenly and get worse quickly. Symptoms of noncancerous heart tumors may develop more gradually.

Signs and symptoms of cardiac tumors include:

What causes cardiac tumors?

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

The spread of cancer from one part of your body (like your lungs or skin) to your heart causes metastatic heart tumors.

Diagnosis and Tests

How are cardiac tumors diagnosed?

Cardiac tumors are diagnosed through imaging tests. Your provider may suspect you have a heart tumor and run some tests to find out. Or, they may run tests for other reasons and find a tumor without expecting it.

When someone has cancer elsewhere in their body along with sudden heart problems, their provider may suspect a heart tumor. So, imaging tests can check if the cancer has spread to their heart.

Primary heart tumors are often difficult to diagnose because signs and symptoms are similar to those of other conditions. Providers may suspect a tumor in people who have symptoms of heart failure without a clear cause. But usually, providers diagnose primary heart tumors through tests they’ve ordered to check for other conditions. These are known as incidental findings.

Most heart tumor signs and symptoms are non-specific and could indicate many possible problems. But there’s one sign unique to heart tumors. Your provider may be able to hear a characteristic “tumor plop” when listening to your heart through a stethoscope. They’ll hear this sound if the tumor physically blocks your mitral valve. It’s similar to what your provider would hear if you had mitral valve stenosis.

So, if your provider hears this sound, they may suspect you have a heart tumor, especially if you don’t have risk factors for mitral valve stenosis.

What tests will be done to diagnose cardiac tumors?

Imaging tests are essential for diagnosing, treating and monitoring heart tumors. Your provider may run one or more of the following tests to reach a diagnosis:

  • Transthoracic echocardiogram. This form of echo is helpful for finding tumors in your ventricles (lower chambers of your heart).
  • Transesophageal echocardiogram. This form of echo is helpful for finding tumors in your atria (upper chambers of your heart).
  • Cardiac MRI. This test helps identify details about the tumor, like whether it’s cancerous.
  • Contrast-enhanced cardiac CT scans. This test is useful for people who have implanted devices and can’t undergo an MRI. It’s also valuable for evaluating your entire chest area (including lungs and blood vessels) and your coronary arteries.
  • PET scan. This test is sometimes used to check if cancer in another part of your body has spread to your heart.

Management and Treatment

What is the treatment for cardiac tumors?

Treatment options for cardiac tumors vary based on the type of tumor.

  • Noncancerous primary heart tumors: Surgery is very successful at removing these tumors if they’re small. Larger tumors may be impossible to remove. Your provider or your child’s provider will recommend surgery if the tumor interferes with heart function. Children who have surgery to remove a fibroma may also need reconstructive surgery to fix damage to their heart.
  • Cancerous primary heart tumors: These tumors can’t be removed and are often fatal. Chemotherapy or radiation may be used to slow the cancer’s progression. Your provider may also provide medications to manage complications.
  • Metastatic heart tumors: Treatment depends on the source of the cancer. It may include chemotherapy or surgical removal of the tumor. Your provider may insert tubes in your chest to drain excess fluid from the tumor. They may also inject medications into your heart to slow tumor growth or combat fluid buildup.

Outlook / Prognosis

What is the outlook for people with heart tumors?

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

  • Myxomas can usually 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.

How long can you live with a cardiac tumor?

Your provider will discuss your individual prognosis with you. In general, people with noncancerous heart tumors have a better prognosis than people with cancerous tumors.

Cancerous primary heart tumors reduce your life expectancy. Overall:

  • About 50% of people live one year after diagnosis.
  • About 24% live three years.
  • About 19% live five years.

Life expectancy also depends on the form of heart cancer.

  • Sarcoma: People with sarcoma survive an average of nine to 17 months following diagnosis.
  • Lymphoma: People with lymphoma survive an average of seven months. With treatment, they may survive up to five years. Without treatment, they may only survive for one month.
  • Cancerous paraganglioma: This condition is often treatable. About 84% of people survive 10 years after a successful surgery. But there’s a 50% chance of the cancer coming back. You’ll need routine imaging tests to check for recurrence.

Living With

When should I see my healthcare provider?

If you’ve been diagnosed with a cardiac tumor, it’s important to closely follow your provider’s guidance. Your provider will tell you how often you need to come in for appointments and what your treatment plan will be. 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 with your provider and routine 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 was diagnosed with a cardiac tumor, their provider will explain next steps. Your child may need treatment right away.

What questions should I ask my provider?

Talk with your provider about your diagnosis, treatment plan and prognosis. You may want to ask:

  • What type of tumor do I have? Is it cancerous?
  • How might this tumor affect my heart?
  • What’s the best way to treat this tumor?
  • How soon do I need treatment?
  • What’s my outlook following treatment?
  • How often do I need to come back for follow-ups or additional tests?

If your child has a heart tumor, ask their provider:

  • What type of tumor does my child have? Is it cancerous?
  • How might this tumor affect my child’s heart and overall health?
  • Will my child need surgery? If so, how soon?
  • What’s the outlook for my child?
  • What can I do at home to take care of my child?
  • Which symptoms should I look out for? What should I do if I notice these symptoms?

A note from Cleveland Clinic

Cardiac tumors can affect your body and your life in many different ways. Often, noncancerous tumors can be successfully removed. Other tumors, including cancerous ones, may be harder to treat. Talk with your provider to learn more about your specific diagnosis and what it means for you.

Last reviewed by a Cleveland Clinic medical professional on 04/29/2022.

References

  • British Heart Foundation. All about Cardiac Tumors. (https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/all-about-cardiac-tumours) Accessed 4/29/2022.
  • European Society of Cardiology. Cardiac Tumors. (https://www.escardio.org/Education/Practice-Tools/EACVI-toolboxes/3D-Echo/cardiac-tumors) Accessed 4/29/2022.
  • Marwick TH, DeMaria AN, Blanchard DG, Zoghbi WA. Echocardiography. In: Fuster V, Harrington RA, Narula J, Eapen ZJ. eds. Hurst’s The Heart, 14e. McGraw Hill; 2017.
  • Merck Manual Professional Version. Cardiac Tumors. (https://www.merckmanuals.com/professional/cardiovascular-disorders/cardiac-tumors/cardiac-tumors) Accessed 4/29/2022.
  • Merck Manual Consumer Version. Myxomas. (https://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/heart-tumors/myxomas?query=Cardiac%20Tumors) Accessed 4/29/2022.
  • Merck Manual Consumer Version. Overview of Heart Tumors. (https://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/heart-tumors/overview-of-heart-tumors?query=Cardiac%20Tumors) Accessed 4/29/2022.
  • Reejhsinghani RS, Redberg RF. Cardiac Tumors. In: Crawford MH. eds. Current Diagnosis & Treatment: Cardiology 5e. McGraw Hill; 2017.

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