Cardiac tumors Notes

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Cardiac tumors

NOTES NOTES CARDIAC TUMORS GENERALLY, WHAT ARE THEY? PATHOLOGY & CAUSES ▪ Abnormal cell growth forms mass in heart TYPES Primary ▪ Rare ▫ Adults: myxoma ▫ Children: rhabdomyoma Secondary ▪ More common than primary ▪ Metastases from cancer in other areas (lung cancer, lymphoma, breast cancer, leukemia, melanoma, hepatocellular carcinoma, colon cancer) ▫ Lymphogenous/hematogenous dissemination COMPLICATIONS ▪ Impaired left ventricular structure, filling, ejection caused by tumor ▪ Arrhythmias: tumor disrupts normal nodal/ septal electrical conduction ▪ Heart failure: tumor obstructs inflow/ outflow ▪ Recurrence of tumor after excision (if tumor not completely removed) ▪ Embolism, sudden cardiac death, myocardial infarction SIGNS & SYMPTOMS ▪ Asymptomatic ▫ Incidental finding on echocardiogram, MRI, CT scan ▪ Dyspnea ▫ Most common symptom ▫ Can progress to orthopnea, paroxysmal nocturnal dyspnea ▪ “Tumor plop” sound upon auscultation with left atrial myxoma ▪ Syncope, presyncope, dizziness, chest pain/ tightness DIAGNOSIS DIAGNOSTIC IMAGING ▪ MRI, CT scan, ultrasound ▫ Incidental finding ▫ See individual disorders ▪ 2D echocardiogram preferred procedure LAB RESULTS ▪ Histology conducted on biopsy via surgical excision/fine needle aspiration TREATMENT SURGERY ▪ Symptomatic: surgical resection OTHER INTERVENTIONS ▪ Asymptomatic: monitor OSMOSIS.ORG 29
ATRIAL MYXOMA osms.it/atrial-myxoma PATHOLOGY & CAUSES SIGNS & SYMPTOMS ▪ A benign heart tumor ▪ Most common primary cardiac tumor in adults ▪ Arises in heart’s mesenchymal connective tissue ▪ Most common in left atrium, may cause syncope ▫ Tumor in left atrium → obstructs mitral valve ▪ Histology ▫ Pedunculated (attached to tissue stalk) ▫ Gelatinous due to abundance of ground substance ▪ Asymptomatic: incidental finding on echocardiogram, MRI, CT scan ▪ Dyspnea: most common symptom ▫ Can progress to orthopnea, paroxysmal nocturnal dyspnea ▪ “Tumor plop” sound upon auscultation with left atrial myxoma ▪ Syncope, presyncope, dizziness, chest pain/ tightness RISK FACTORS ▪ Age 40–60 ▪ More common in biological females ▫ Less pronounced in familial atrial myxoma ▪ Genetic disease DIAGNOSIS LAB RESULTS Histology ▪ Stellate myxoma cells in myxoid stroma of glycosaminoglycans TREATMENT SURGERY ▪ Symptomatic: resection OTHER INTERVENTIONS ▪ Asymptomatic: monitor Figure 5.1 Surgically excised atrial myxoma. A small piece of myocardium marks the point of attachment. 30 OSMOSIS.ORG
Chapter 5 Cardiac Tumors Figure 5.2 Histological appearance of a myxoma with abundant mucoid matrix (pink background) and scanty, bland spindle cells with low mitotic activity. Figure 5.3 A sagittal CT scan demonstrating a myxoma in the left atrium. RHABDOMYOMA osms.it/rhabdomyoma PATHOLOGY & CAUSES ▪ Benign tumor of striated muscle ▪ Most common primary cardiac tumor in infants/children ▪ Arises in ventricles ▪ Presents congenitally ▪ Benign hamartoma (abnormal tissue formation) ▪ Association between rhabdomyoma/ tuberous sclerosis about 30–50% ▪ Often regresses spontaneously ▪ Shrink with age RISK FACTORS ▪ More common in children ▪ More common in biological males (2.4:1 male-female ratio) ▪ Average presentation age is four years old ▪ Associated with nevoid basal cell carcinoma syndrome ▪ Genetic disease DIAGNOSIS DIAGNOSTIC IMAGING MRI, CT scan, ultrasound ▪ Incidental finding Ultrasound, MRI ▪ Visualize tumor LAB RESULTS Histology ▪ Hamartomatous growths surrounded in a glycogen-rich eosinophilic cytoplasm OSMOSIS.ORG 31
SIGNS & SYMPTOMS ▪ Usually present at birth ▪ Tender, painful, benign, slow-growing nodules ▫ Common in neck/mouth/larynx, may cause breathing difficulties TREATMENT SURGERY ▪ Symptomatic: surgical resection Figure 5.4 A surgically excised rhabdomyoma. OTHER INTERVENTIONS ▪ Asymptomatic: monitor Figure 5.5 Histological appearance of a rhabdomyoma composed of plump, pink skeletal muscle cells. 32 OSMOSIS.ORG

Osmosis High-Yield Notes

This Osmosis High-Yield Note provides an overview of Cardiac tumors essentials. All Osmosis Notes are clearly laid-out and contain striking images, tables, and diagrams to help visual learners understand complex topics quickly and efficiently. Find more information about Cardiac tumors by visiting the associated Learn Page.