Heart Tumors

Cardiac tumors may be primary neoplasms (benign or malignant) or metastasis of a tumor to be non-cardiac (malignant). The myxoma, a benign primary cardiac tumor is the most common type. Heart tumors can occur in all cardiac tissues. You can flaps narrowing or inflow and outflow tract obstruction, thromboembolism, arrhythmias or pericarditis cause. The diagnosis is made by echocardiography and cardiac MRI often. The treatment of the benign tumor is usually surgical resection; Tumors can rezidiveren. The treatment of cardiac metastases depends on the tumor type and origin; the prognosis is generally poor.

Primary cardiac tumors are found in <1/2000 people at autopsy. Metastases are 30 to 40 times more common than primary cardiac tumors. Typically, the primary tumor starts from the heart myocardium or endocardium; He can also start from the valve tissue or connective tissue of the heart or the pericardium.

Cardiac tumors may be primary neoplasms (benign or malignant) or metastasis of a tumor to be non-cardiac (malignant). The myxoma, a benign primary cardiac tumor is the most common type. Heart tumors can occur in all cardiac tissues. You can flaps narrowing or inflow and outflow tract obstruction, thromboembolism, arrhythmias or pericarditis cause. The diagnosis is made by echocardiography and cardiac MRI often. The treatment of the benign tumor is usually surgical resection; Tumors can rezidiveren. The treatment of cardiac metastases depends on the tumor type and origin; the prognosis is generally poor. Primary cardiac tumors are found in <1/2000 people at autopsy. Metastases are 30 to 40 times more common than primary cardiac tumors. Typically, the primary tumor starts from the heart myocardium or endocardium; He can also start from the valve tissue or connective tissue of the heart or the pericardium. Classification Some of the most common primary and secondary cardiac tumors are listed below (see table: types of heart tumors). Primary cardiac tumors can be benign (nearly 80% of cases) Malignant (the remaining 20%) benign primary tumors examples are myxoma, papillary Fibroelastome, rhabdomyoma, fibroma, hemangioma, teratoma, lipomas, paragangliomas and pericardial cysts. Myxoma are most common, with a proportion of 50% of all primary cardiac tumors. The incidence in women is 2 to 4 times higher than in men. On rare fämiliären forms (Carney complex) Men are more likely than women affected. About 75% of myxomas occur in the left atrium; the rest occurs in other chambers of the heart as a solitary tumor or, less frequently, in different places. Myxoma can be up to 15 cm in diameter. About 75% are stalked and can prolapse through the mitral valve and hinder the filling of the ventricle during diastole. The remaining tumors are sessile sessile and firmly seated. Myxoma may be myxoid and gelatinous, smooth, firm and lobed or crumbly and irregular. Friable irregular myxomas have an increased risk of systemic embolization. The Carney complex is a familial autosomal dominant inherited syndrome of recurrent cardiac myxoma, along with various combinations of cutaneous myxomas, myxoid fibroadenomas of the breast, pigmented skin lesions (lentigo, Ephelide, blue nevi), multiple endocrine neoplasia (primary pigmented nodular adrenocortical disease, the Cushing's syndrome caused growth hormone and pituitary adenoma prolactinproduzierendes, testicular cancer, thyroid adenomas or carcinomas and ovarian cysts) psammomatösen melanotic schwannomas, ductal breast adenoma and Osteochondromyxom. Patients are often in the event jüngen age (median age: 20 years), have multiple myxoma (va in the ventricles..) And a higher risk of recurrence. Papillary Fibroelastome are the second most common benign primary tumors of the heart. These are avascular papillomas, which occur in 80% of cases on the heart valves. The papillomas tend to occur on the left side of the heart), mainly on the aortic and mitral valves. Men and women are equally affected. You have papillary septa who see from a central core of branch, and a sea anemone similar. About 45% are stalked. They do not cause valve dysfunction, but there is the risk of embolism. The proportion of rhabdomyomas to the primary cardiac tumors is 20% in children 90%. Rhabdomyomas relate mainly infants and children, of whom 80% suffer from a tuberous sclerosis. Rhabdomyomas are usually multiple and occur on intramural in the septum or free wall of the left ventricle, where they affect the conduction system. It is hard white nodules that are typically regresses with age. A minority of patients develop tachyarrhythmias and heart failure due to left ventricular outflow tract obstruction. Fibroids also relate mainly children; they are associated with adenomas sebaceum the skin and kidney tumors. They occur primarily on the left side of the heart to, are often located in the ventricular myocardium and can arise in response to an inflammatory response. You can compress the conduction system or grow into this, which arrhythmias and sudden death caused. Some fibroids occur as part of a syndrome with generalized overgrowth, Kieferkeratozyten, skeletal changes and different benign and malignant tumors (Gorlins - or basal cell). The proportion of hemangiomas is 5 to 10% of the benign tumors. They cause symptoms in a minority of patients. They are usually discovered by chance during an investigation for other reasons. Teratomas pericardium relate mainly infants and children. They are often placed near the base of the great vessels. About 90% are located in the anterior mediastinum, the rest mainly in the posterior mediastinum. Lipomas can occur in a broad age range. They arise in the endocardium or epicardium and have a large, stalked basis. Many are asymptomatic, but some lead to the outflow tract obstruction or arrhythmias. . Paragangliomas, including pheochromocytomas rarely occur in the heart; if they are, they are usually isolated vagus at the base of the heart near the terminations of the N.. They can lead to symptoms due to the catecholamines (eg. As increased heart rate and blood pressure, excessive sweating, tremor). Paragangliomas can be benign or malignant. Pericardial cysts may resemble the X-ray image of a heart tumor or a pericardial effusion. They are usually asymptomatic, although some compression symptoms cause (z. B. chest pain, dyspnea, cough) .Primär malignant tumors to the primary malignant tumors are sarcomas, pericardial mesothelioma and primary lymphomas. The sarcoma is the most common malignancy and the second most common primary cardiac tumors (after myxoma). Sarcomas affect adults in middle age (average 41 years old). Almost 40% are angiosarcoma, most of the right atrium of which emerge and affecting the pericardium, whereby obstruction of the right ventricular outflow tract, pericardial tamponade, and lung metastases can occur. Other species are undifferentierte sarcomas (25%), malignant fibrous histiocytomas (11-24%), leiomyosarcomas (8-9%), fibrosarcoma, rhabdomyosarcoma, liposarcoma and osteosarcoma; in these species it is more likely to come from the left atrium and cause Mitralklappenobstruktion and heart failure. DasPerikardiale Mesothelioma is rare. It affects all ages, men more often than women. It causes a tamponade and constriction and can metastasize into the vortex, into adjacent soft tissues and in the brain. Dasprimäre lymphoma is extremely rare. It usually occurs in AIDS patients or people with immune deficiency. These tumors grow quickly and cause heart failure, arrhythmias, tamponade and the V. cava superior (SVC) Syndrom.MetastasierteTumoren Melanoma is a tumor with a high propensity for cardiac involvement. Lung and breast cancers, soft tissue sarcomas and kidney cancers are also common sources of metastases in the heart. Leukemias and lymphomas frequently metastasize to the heart, but the metastases may be clinically insignificant. If the Kaposi's sarcoma spreads systemically in immunodeficiency (usually AIDS), it can affect the heart, but clinical cardiac complications are rare. Types of cardiac tumors examples type Benign primary tumors myxoma Papillary Fibroelastome rhabdomyomas fibroids hemangiomas teratomas lipomas Paraganglionome * Pericardialzysten Primary malignant tumors sarcomas pericardial mesothelioma Primary lymphoma tumor metastasis carcinoma breast cancer soft-tissue sarcoma, renal carcinoma melanoma Paragangliomas may be malignant. Symptoms and complaints cardiac tumors cause symptoms and findings that are typical (z. B. heart failure, stroke, coronary heart disease) for far more common diseases. The symptoms and findings primarily benign cardiac tumors depend on the tumor type, the location, size and friability. Types of symptoms and signs Symptoms can be classified as extracardially intramyocardial intracavernous Extracardiac symptoms and complaints may be constitutionally or mechanically. Constitutional symptoms such as fever, chills, lethargy, arthralgia, and weight loss are caused exclusively by myxomas, possibly as a result of cytokine release (eg., IL-6). Petechiae may also occur. These and other findings may erroneously suggest a bacterial endocarditis, connective tissue disease or a hidden cancer. In some tumors (particularly gelatinous myxomas) can thrombi or tumor fragments into the systemic circulation (eg., Brain, coronary arteries, kidneys, spleen, limbs) or embolize to the lungs and cause-specific manifestations in these organs. Mechanical symptoms (. Eg, dyspnea, malaise in the chest) caused by compression of the chambers of the heart or the coronary arteries, or by a Perikardirritation or -tamponade; they are caused by the growth and haemorrhage in the pericardium. Tumors of the pericardium can cause pericardial friction sounds. Intramyocardial Symptoms caused by arrhythmias, usually by atrioventricular or intraventricular conduction blocks, or paroxysmal supraventricular and ventricular tachycardia due to pressure on the cardiac conduction system, or very little disturbance of which (in particular by rhabdomyomas and fibroids). Intracavernous Symptoms are caused by tumors that obstruct the valve function, blood flow, or both (thus Klappenstenosen, valvular insufficiency or heart failure cause). Intracavernous Symptoms can vary with the body position, the hemodynamics and physical forces associated with the tumor, verändert.Symptome and signs of tumor type myxoma can manifest itself in the Triad heart disease, embolic disease and constitutional symptoms. Myxomas can cause a diastolic murmur that is similar to the mitral, but its volume and location changes from beat to beat to the body ply. About 15% of pedunculated left atrial myxoma elicit an audible "tumor plop" when they fall into the Mitralöffnung during diastole. Myxoma can also cause arrhythmias. Raynaud's syndrome and finger clubbing are less typical, but may occur. Fibroelastome that are often discovered by chance during an autopsy, are usually asymptomatic; However, they can be a source of systemic embolism. Rhabdomyomas are usually asymptomatic. Fibroids cause arrhythmias and sudden cardiac death. Hemangiomas are usually asymptomatic, but can all extracardiac, intramyocardial cause or intracavernous symptoms. Teratomas cause dyspnea and cyanosis due to the compression of the aorta or of the pulmonary artery or on the basis of a SVC syndrome. Symptoms of malignant cardiac tumors are more acute in the beginning and proceed more quickly than those who continued benign tumors. Cardiac sarcomas cause regular way symptoms of ventricular inflow tract obstruction or pericardial tamponade. Mesotheliomas lead to symptoms of pericarditis or tamponade. Primary lymphoma cause refractory progressive heart failure, tamponade, arrhythmias, and an SVC syndrome. Tumor metastases in the heart can be manifest (due to rapid accumulation of a hemorrhagic pericardial effusion), conduction block, arrhythmia or sudden unexplained heart failure as sudden cardiac enlargement, tamponade. Fever, Elendsein, weight loss, night sweats and loss of appetite may also be present. Diagnostic echocardiography cardiac MRI, the diagnosis that is made often delayed because the symptoms and findings are similar to more common diseases is confirmed by echocardiography. The transesophageal echocardiography is more suitable for displaying atrial tumors; transthoracic echocardiography which is more suitable for displaying Ventrikeltumoren. A cardiac MRI is often used to identify tumor tissue properties and provides clues to denTumortyp. If the results are not clear imaging with radionuclides and CT may be useful. A biopsy is not performed normally because imaging studies can distinguish between benign and malignant tumors often. Extensive research going in patients with myxomas often echocardiography ahead because their symptoms are non-specific. Anemia, thrombocytopenia and an increase in white blood cell count, the ESR, C-reactive protein and gamma globulins are common. The ECG may show an enlargement of the left atrium. The standard chest X-ray recording can show calcium deposits in right atrial myxoma or teratomas, which impress as a mass in the anterior mediastinum. Myxomas are sometimes diagnosed when tumor cells are found in surgically removed emboli. Atrial myxoma © Springer Science + Business Media var model = {thumbnailUrl: '/-/media/manual/professional/images/522-atrial-myxoma-s115-springer-high_de.jpg?la=de&thn=0&mw=350' imageUrl: '/-/media/manual/professional/images/522-atrial-myxoma-s115-springer-high_de.jpg?la=de&thn=0', title: 'myxoma' description: ' u003Ca id = "v37893620 "class = " anchor "" u003e u003c / a u003e u003cdiv class = "" para "" u003e u003cp u003eDieses image shows a myxoma (by the asterisk in) into the right atrium (RA). also visible in this echocardiographic image are the left atrium (LA)

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