Cancer of the heart: epidemiology and management of primary tumors and metastases.

Cardiac tumors, benign or malignant, are rare and most are benign. The most common benign tumor is the cardiac myxoma. Malignant cardiac tumors are usually sarcomas. The pericardium can be the site of benign and malignant cardiac tumors, though metastatic tumors occur here far more commonly than do primary tumors. Successful treatment for benign cardiac tumors is usually achieved by surgical resection. Surgery for primary malignant tumors is, however, much less successful as complete resection is usually not possible. Primary cardiac lymphoma may be successfully treated by chemotherapy. Tumors that metastasize to the heart from other organs occur 100- to 1000-fold more commonly than primary cardiac tumors. Metastatic spread to the heart has been identified in approximately one-fifth of all patients who have metastatic cancer with lung carcinoma being the most common primary tumor. Symptoms of cardiac metastases vary, and they depend on the site and extent of the lesions. Treatment varies depending on the pathology of the primary tumor. However, the aim of treatment is usually symptomatic relief. With the advent of AIDS, Kaposi's sarcoma and high grade B cell lymphomas have also been identified in cardiac tissue. The aim of this article is to review the epidemiology, clinical presentation, pathology and treatment of cardiac tumors.