The latter can form directly in the heart or result from another cancer. For example, metastases can form in the heart in the case of black skin cancer, breast cancer or lung cancer. The heart tumor often becomes noticeable through general symptoms, such as a slight fever or shortness of breath. We usually try to remove the heart tumor during an operation.
What is a heart tumor?
Cardiac tumors are rare. They account for only about 0.02 percent of all tumors in humans. Researchers arrived at this figure from studies in which an autopsy was performed. It is not possible to put an exact figure on how many people contract the disease. The figures vary between 18 in 1,000,000 and 28 in 10,000. Experts believe that the reason for this rarity is that, unlike cells in other tissues, heart cells divide only rarely.
Cardiac tumors can be benign or malignant. It is typical of benign tumors that they can grow but do not invade surrounding tissue and other organs. Malignant tumors, on the other hand, have precisely this ability, and these cancer cells can also spread to other regions of the body and form metastases there.
Primary and secondary cardiac tumor
Experts differentiate between heart tumors according to their place of origin: A primary heart tumor forms first in the heart. It can be benign or malignant. A secondary heart tumor, on the other hand, has its roots in another organ. For example, lung or breast cancer can spread to the heart and form metastases there. Secondary cardiac tumors are therefore always malignant.
Benign heart tumors occur much more frequently than malignant ones. Approximately two thirds of tumors are benign and one third are malignant. In adults, myxoma is the most common benign heart tumor. Women often fall ill in middle age. In children, on the other hand, rhabdomyomas are found more frequently.
Primary benign cardiac tumors: Types, incidence and age
In around 75 percent of cases, primary heart tumors are benign. There are many different types of benign heart tumors – the most common variants are:
- Myxomas: At around 50 percent, they account for the majority of cardiac tumors. They usually develop spontaneously and rarely run in families. Around 75 percent of myxomas form in the left atrium, 23 percent in the right atrium and very rarely in the ventricles. The myxoma is spherical and has a stalk.
- Lipomas: They are responsible for around ten to 20 percent of all benign heart tumors. Encapsulated fat deposits can be detected in lipomas. They can grow to different sizes and develop anywhere in the heart. They are often found in the left ventricle or the right atrium.
- Papillary fibroelastomas: This heart tumor affects the heart valves, usually the aortic or mitral valves. It accounts for around eight percent of all benign heart tumors. Papillary fibroelastomas usually occur at an advanced age.
- Rhabdomyomas: These cardiac tumors are found particularly often in children and extremely rarely in adults. Around a third of children are younger than one year old when they are diagnosed. Rhabdomyomas often occur in connection with a disease called tuberous sclerosis (approx. 80 percent). This hereditary disease is associated with tumors in various organs and skin changes. The rhabdomyoma often develops in the wall layer of the right or left ventricle.
- Fibromas: Fibromas are the second most common benign heart tumors in children. In adults, they account for around three percent of all benign heart tumors. Fibromas invariably form in the wall layer of the ventricles, usually in the left ventricle or the wall between the two ventricles. They can grow to between one and ten centimeters in size. Calcium deposits can often be detected in the center of the fibroma.
- hemangiomas: They originate in the vascular system. Hemangiomas account for around two percent of all primary, benign heart tumors. In principle, they can occur at any age. Occasionally they occur in connection with similar tumors in the gastrointestinal tract or the skin. Hemangiomas can form in all chambers of the heart, but they usually affect the ventricles.
Primary malignant cardiac tumors: Types, incidence and age
More rarely (approx. 25 percent of cases), primary cardiac tumors are malignant. They usually grow quickly and the cancer spreads rapidly. Various heart structures are affected, such as the myocardium, the heart chambers and the pericardium. Sarcomas are the most common – at around 95 percent.
In general, sarcomas arise either from connective and supporting tissue such as bone, cartilage and fatty tissue or from muscle tissue. It often affects people between the ages of 30 and 50, both men and women. Sarcomas are considered to be very aggressive and the prognosis is unfavorable in many cases.
Malignant primary heart tumors include, for example
- Angiosarcoma: This malignant heart tumor particularly often affects middle-aged men. Angiosarcomas develop preferentially in the right side of the heart, usually in the right atrium. Angiosarcoma is the most common malignant heart tumor, accounting for around 30 percent of cases. It develops from precursor cells that later transform into certain cells of the blood vessels.
- Rhabdomyosarcomas: They arise from the striated muscles of the heart. At around 20 percent, rhabdomyosarcoma is the second most common malignant heart tumor. It is more common in children. Rhabdomyosarcomas can develop in any chamber of the heart. In around 60 percent of children, they form in several chambers at the same time. Similar to angiosarcomas, they grow quickly and spread rapidly. Rhabdomyosarcoma has often already spread to the pericardium before diagnosis.
- Fibrosarcomas: They make up around ten percent of all malignant heart tumors and develop from the fibroblasts of the cardiac connective tissue. Adults in particular suffer from fibrosarcomas. They are usually found in the right atrium. They can extend to the pericardium.
- Leiomyosarcomas: They grow particularly aggressively and originate in the smooth heart muscle cells. Leiomyosarcoma accounts for around nine percent of malignant heart tumors. It occurs at any age and equally in men and women.
- LymphomasThey account for only about five percent of all malignant heart tumors. They can occur particularly in people with a suppressed immune system. Primary cardiac lymphomas usually affect the right side of the heart. They can also occur as a result of non-Hodgkin’s lymphoma (secondary), when the cancer spreads to the heart.
- MesotheliomasThese malignant heart tumors are very rare. In contrast to mesothelioma of the pleura and peritoneum, they are not associated with exposure to asbestos.
Secondary malignant cardiac tumors
Secondary malignant heart tumors have their origin in cancer of another organ. These are metastases (metastases) that form in the heart. The cancer cells can spread from the original organ via the blood and lymph channels to the heart. The direct penetration of malignant tumor cells into the heart is also possible. Heart metastases particularly often affect the pericardium. Around ten percent of people with cancer develop metastases in the heart. The following types of cancer can be the causes:
Heart tumor: causes are usually unclear
The causes of primary cardiac tumors are unknown in many cases. It is unclear why the tissue in the heart changes, multiplies and begins to proliferate. The cause of secondary cardiac tumors, which are always malignant, is known: It lies in a cancer that has originated in another organ. Cancer cells can reach other organs – including the heart – via the blood and lymph channels, but also directly.
Symptoms: Heart tumors cause various symptoms
Cardiac tumors do not necessarily cause symptoms. But if they grow or are in an unfavorable position, they usually become noticeable. The symptoms can vary in severity. They depend on how large the tumor is, where it has formed and how severely it affects heart function.
Malignant tumors in the heart often grow rapidly and quickly affect the heart. However, benign heart tumors can also become very large and disrupt heart function. They can therefore also be fatal.
The following general symptoms may indicate a heart tumor:
- Slightly increased body temperature
- Weight loss
- Tiredness, fatigue, exhaustion
- Decrease in physical performance
- Muscle pain, joint pain
- Night sweats
- Cough
- Reddening of the skin – red spots on the skin
The following complaints are also possible:
- Shortness of breath – depending on posture
- Chest tightness
- Chest pain
- Cardiac arrhythmia(heart stumbling / palpitations)
- Signs of heart failure, e.g. shortness of breath, water retention in the legs (edema)
- Symptoms of an embolism, e.g. palpitations, anxiety, dizziness or fainting spells
Always visit us promptly if you suffer from these or other symptoms. We try to find out what is behind your complaints.
Heart tumor: Diagnosis with us
The diagnosis of cardiac tumors is a real challenge for us too. Cardiac tumors are extremely diverse and therefore difficult to diagnose. The symptoms are also often unspecific and can occur in many other diseases. We will first ask you (in the case of children, the parents) about your medical history (anamnesis). The following questions, for example, are interesting:
- What exactly are the symptoms you suffer from?
- How long have you had the symptoms and how severe are they?
- Do the symptoms improve or worsen in certain situations, e.g. in certain postures?
- Do you have any known illnesses, for example cancer? If yes: What type of cancer?
- Have you undergone any treatments or do you regularly take medication? Which?
These and other questions give us an initial indication and we can make a rough assessment. This is followed by a physical examination, during which we listen to the heart and lungs and palpate the body for any abnormalities. A blood test is usually standard. The blood values provide general information about the condition of the organs.
Imaging procedures that can show changes in the heart are usually the most informative. Frequently used:
- Heart ultrasound (echocardiography): This method works with sound waves and can detect a wide variety of heart diseases. It is considered the most important examination method in the diagnosis of cardiac tumors. There are different types of echocardiography, for example from the outside via the skin or via the esophagus (transesophageal echocardiography = TEE).
- Computed tomography (CT): An X-ray examination in which radiologists produce precise cross-sectional images of the heart.
- Magnetic resonance imaging (MRI = magnetic resonance imaging): This examination works with strong magnetic fields and also provides detailed cross-sectional images of the heart.
- Positron emission tomography (PET), usually in combination with a CT (= PET/CT) or with an MRI (= PET/MRI): PET can visualize areas in the body where the metabolism is particularly active. This also includes cancer cells. We use low-level radioactive substances (tracers) such as 18F-fluorodeoxyglucose, which accumulate in metabolically active regions. In this way, benign and malignant heart tumors can often be distinguished or malignant tumors can be detected.
- Tissue sample (biopsy) – if lymphoma is suspected.
Once we have diagnosed a malignant heart tumor, further examinations usually follow to determine the stage and spread of the cancer.
Heart tumor: prevention, early detection, prognosis
They cannot really prevent a heart tumor because in many cases the causes are unknown. Why primary heart tumors develop – whether benign or malignant – often remains a mystery. There are therefore no special measures for early detection. It is generally advisable to visit us if you have any complaints.
Secondary cardiac tumors are always malignant. They are caused by cancer in another organ, for example black skin cancer, breast cancer or lung cancer. Some preventive measures are known for some of these cancers. Nevertheless, cancer can never be prevented with 100 percent certainty.
Course and prognosis of a heart tumor
The course and prognosis of cardiac tumors depend on various factors. No generally valid statements can be made. First of all, it is important to determine whether the heart tumor is benign or malignant. The prognosis for malignant heart tumors is often very unfavorable because they grow quickly and can severely impair heart function.
But even benign tumors can take on larger dimensions if we do not treat them. Then they also significantly disrupt the pumping function of the heart. In addition, parts of the heart tumor or blood clots can enter the bloodstream and trigger an embolism. The consequences can be a stroke, heart attack or circulatory problems in the legs.
Rapid treatment is therefore always important – usually in the form of surgery – to prevent the tumor from growing further.
Heart tumor: treatment usually involves surgery
Treating a heart tumor is also a complex matter for us. It is therefore important that you seek treatment at our specialized heart center. We work together with doctors from various specialties who have experience in the treatment of heart tumors.
The following treatments are possible for a heart tumor:
- Surgery: This is the most important treatment strategy for a heart tumor. Cardiac surgeons remove the tumor in the heart as completely as possible during the operation. A heart-lung machine is used because the heart is “immobilized” during the operation. There are various, sometimes complicated, surgical techniques that require a great deal of medical skill and experience from a heart surgeon.
- Heart transplantation: This is considered a last resort and requires that there are no distant metastases in other organs. However, donor organs are in short supply in many countries, including Switzerland. Many patients are on the waiting list for a new organ.
Additional treatments for malignant heart tumors
In the case of a malignant heart tumor, the following treatments are also possible:
- Chemotherapy: We use strong cytotoxins, so-called cytostatics or chemotherapeutics. They act throughout the entire body (systemically). We usually administer the medication in certain combinations and in cycles. There are treatment-free periods between the individual chemotherapies.
- Radiotherapy: Radiologists direct high-energy ionizing radiation against any remaining cancer cells that damage the genetic material. Unlike healthy cells, cancer cells can no longer repair this damage and die. The radiation works locally on site. You usually have to complete the sessions daily over several weeks.