Cardiac Tumors

Question 1

What are cardiac tumors?

Answer 1

Uncommon tumors that can be primary (originating in the heart) or metastatic (spreading from other sites).

Question 2

What is the incidence of primary cardiac tumors?

Answer 2

Between 0.001% and 0.3% based on autopsy studies.

Question 3

What are the three main clinicopathological groups of primary cardiac tumors?

Answer 3

Benign congenital tumors, benign acquired tumors, and malignant tumors.

Question 4

What percentage of primary cardiac tumors are benign?

Answer 4

About 90%.

Question 5

What is the most common primary cardiac tumor?

Answer 5

Myxoma.

Question 6

Where are cardiac myxomas most commonly located?

Answer 6

In the left atrium (80%), followed by the right atrium and ventricles.

Question 7

What genetic syndrome is associated with cardiac rhabdomyomas?

Answer 7

Tuberous sclerosis.

Question 8

Which primary malignant cardiac tumor is most common?

Answer 8

Angiosarcoma.

Question 9

What is the most frequent tumor of the heart valves?

Answer 9

Papillary fibroelastoma.

Question 10

What imaging modality is best for evaluating cardiac tumors?

Answer 10

Echocardiography (transthoracic or transesophageal), followed by MRI and CT scan.

Question 11

What is the prognosis of malignant cardiac tumors?

Answer 11

Poor prognosis due to aggressive growth and late diagnosis.

Question 12

What are the common symptoms of cardiac tumors?

Answer 12

Asymptomatic, valvular dysfunction, pericardial effusion, blood flow obstruction, arrhythmias, heart failure.

Question 13

What is the second most frequent primary cardiac tumor?

Answer 13

Lipomas.

Question 14

What is the appearance of lipomas on histology?

Answer 14

Well-circumscribed, encapsulated, yellow masses consisting of fat cells with a fibrous capsule.

Question 15

What are the clinical manifestations of papillary fibroelastoma?

Answer 15

Heart failure symptoms, valvular insufficiency, obstruction, embolization, new murmur.

Question 16

Which cardiac tumor is most common in children?

Answer 16

Rhabdomyomas.

Question 17

What is the characteristic histological feature of rhabdomyomas?

Answer 17

Spider cell appearance due to vacuolated cells with glycogen deposits.

Question 18

What is the primary treatment for symptomatic primary cardiac tumors?

Answer 18

Surgical resection.

Question 19

Which syndrome is associated with cardiac fibromas?

Answer 19

Gorlin syndrome.

Question 20

What cardiac tumors are associated with genetic syndromes?

Answer 20

Rhabdomyomas (tuberous sclerosis), fibromas (Gorlin syndrome), myxomas (Carney complex).

Question 21

What is the most common secondary cardiac malignancy?

Answer 21

Metastatic involvement from lung, breast, esophagus, stomach, kidney, melanoma, lymphoma, leukemia.

Question 22

How does cardiac metastasis typically present?

Answer 22

Heart failure, valvular dysfunction, pericardial effusion, arrhythmias.

Question 23

What cardiac tumor has a ‘sea anemone-like’ appearance?

Answer 23

Papillary fibroelastoma.

Question 24

What is the most common location of angiosarcoma in the heart?

Answer 24

Right atrium.

Question 25

What imaging modality provides the most detailed assessment of cardiac tumors?

Answer 25

Cardiac MRI.

Question 26

What cardiac tumor is commonly associated with embolization?

Answer 26

Myxoma.

Question 27

What is the treatment for malignant cardiac tumors?

Answer 27

Palliative care, chemotherapy, and sometimes surgery.

Question 28

What are the major complications of cardiac tumors?

Answer 28

Stroke, embolization, syncope, arrhythmias, pericardial effusion, tamponade.

Question 29

What is the best diagnostic tool for identifying valvular tumors?

Answer 29

Transesophageal echocardiography (TEE).

Question 30

What is the common histologic finding in fibromas?

Answer 30

Well-circumscribed, firm, white masses with monomorphic fibroblasts.

Question 31

What is the typical appearance of a myxoma on gross pathology?

Answer 31

Gelatinous, polypoid mass attached to the endocardium by a stalk.

Question 32

Which cardiac tumor is known to regress spontaneously?

Answer 32

Rhabdomyomas.

Question 33

What is the most common presenting symptom of left atrial myxoma?

Answer 33

Dyspnea, often worsening in certain positions.

Question 34

What is the relationship between myxomas and embolization?

Answer 34

Due to their friable nature, they frequently embolize, leading to strokes and systemic embolism.

Question 35

Which cardiac tumor commonly presents with pericardial effusion and tamponade?

Answer 35

Metastatic cardiac tumors.

Question 36

Which primary cardiac tumor is most commonly diagnosed in women?

Answer 36

Myxoma.

Question 37

What syndrome is associated with multiple myxomas?

Answer 37

Carney complex.

Question 38

What is the treatment for symptomatic myxomas?

Answer 38

Surgical excision.

Question 39

What are the risk factors for secondary cardiac tumors?

Answer 39

Primary malignancies of the lung, breast, melanoma, lymphoma, leukemia.

Question 40

Which cardiac tumor is often detected incidentally on imaging?

Answer 40

Lipomas.

Question 41

What is the primary risk factor for angiosarcoma?

Answer 41

Unknown, but possibly linked to radiation exposure.

Question 42

What type of cardiac tumor has a high recurrence rate after surgery?

Answer 42

Myxomas in familial cases.

Question 43

What cardiac tumor is commonly associated with heart block?

Answer 43

Fibromas due to involvement of the conduction system.

Question 44

What tumor can mimic infective endocarditis?

Answer 44

Papillary fibroelastoma due to its valvular involvement.

Question 45

How are cardiac tumors typically classified?

Answer 45

Benign vs. malignant, and primary vs. secondary (metastatic).

Question 46

What is the role of biopsy in diagnosing cardiac tumors?

Answer 46

Rarely performed due to the risk of complications; diagnosis is usually based on imaging.

Question 47

What imaging modality helps differentiate benign from malignant cardiac tumors?

Answer 47

Cardiac MRI with contrast enhancement.

Question 48

What cardiac tumors are most likely to cause systemic embolism?

Answer 48

Myxomas and papillary fibroelastomas.

Question 49

What is the prognosis of untreated cardiac myxomas?

Answer 49

Progressive symptoms with a risk of embolization and sudden cardiac death.

Question 50

What is the role of pericardiocentesis in cardiac tumors?

Answer 50

Used to relieve pericardial effusion in metastatic cardiac disease.

Question 51

Which cardiac tumor has the highest likelihood of recurrence?

Answer 51

Myxomas, especially in familial cases.

Question 52

Which primary cardiac tumor is most likely to cause sudden cardiac death?

Answer 52

Fibromas due to arrhythmias.

Question 53

What is the primary treatment for secondary cardiac tumors?

Answer 53

Management of the primary malignancy and symptomatic treatment.

Question 54

Which cardiac tumor can cause mitral or aortic valve obstruction?

Answer 54

Papillary fibroelastoma.

Question 55

What is the most common cardiac tumor in infants?

Answer 55

Rhabdomyomas.

Question 56

What is the most common presenting symptom of metastatic cardiac tumors?

Answer 56

Pericardial effusion with tamponade.

Question 57

What is the role of left heart catheterization in cardiac tumor evaluation?

Answer 57

To assess coronary artery involvement and rule out other cardiac conditions.

Question 58

What is the role of chemotherapy in cardiac tumors?

Answer 58

Mainly for metastatic cardiac tumors, but not effective for primary cardiac tumors.