Suspect the presence of a tumor in the heart. Tumors of the heart: causes, symptoms, diagnosis, treatment. Benign neoplasms of the heart

The heart muscle is not often affected malignant tumors like other internal organs. Perhaps the reason for this is that it feeds on blood better than the rest of the body. Metabolic processes here are faster, which means that the protective reaction is much stronger.

A tumor of the heart can have a primary form and a secondary one. The first group includes benign and malignant neoplasms. The second includes all metastasized cancer cells that approach the heart muscle through the lymphatic pathways and blood flow from the affected organs.

Types of tumors

According to the type of altered cellular structure of a heart tumor, there can be:

benign;
malignant.

Let's consider each type in more detail.

Benign tumor of the heart

This species is primary and originates in cardiac tissues. These include:

Miksomu - is frequent view cardiac tumors, is detected in half of all diagnosed benign tumors. It is noted that the hereditary factor plays an important role in the predisposition to the occurrence of a tumor. The structure of the myxoma may be firm, mucoid, or loose. With a loose structure, tumors are most dangerous due to the fact that malignant degeneration of tissues is possible.
Papillary fibroelastoma. It is considered the second most common type of neoplasm. It is located on the valve papillae (usually aortic or mitral), prevents their full closure at the time of ventricular contraction. When identifying the causes valvular insufficiency often diagnosed. Fibroelastoma has a favorable prognosis, provided timely replacement of damaged valves.
Rhabdomyoma. Most often diagnosed in childhood, located in causes a violation of the conduction of the myocardium. Symptoms of a heart tumor of this type are the appearance of blockades on the ECG and a violation of the heart rhythm. If the rhabdomyoma is located near the sinus node, then severe rhythm disturbances are not ruled out, and cardiac arrest may even occur.
Fibroma. In most cases, it is detected in childhood, it is a tumor process in connective tissue. Can lead to stenosis of the opening between the ventricle and the atrium or to deformation of the valve. Sometimes with external localization on the pericardium, pericarditis is possible. The classification of heart tumors does not end there.
Hemangioma. It is extremely rare and does not cause changes in the work of the heart. Only if it grows into the sinus node, then a failure of the heart rhythm is possible, in severe cases - a fatal outcome.
Lipoma. It can be found in any part of the myocardium. It does not show itself at all at small sizes. Depending on the location of the localization, a strongly overgrown lipoma provokes various heart failures. It is not excluded degeneration into liposarcoma.

Intrapericardial tumor is less common than other localizations. Most often, this tumor is located in the right ventricle of the heart.

Any tumor of the heart, if it is benign, develops in rare cases and is detected before serious disorders in the myocardium. Severe heart failure or cardiac arrest is possible only if a person ignores the symptoms that have arisen for a long time. This cannot be allowed, so you should visit doctors in a timely manner and undergo comprehensive examination at cardiologists.

Malignant tumors

These neoplasms are extremely dangerous. Tumor of the heart in the primary form is extremely rare. As a rule, a malignant process develops during metastasis. According to the nature of cancer cells, it can be:

angiosarcoma (similar to the vascular epithelium in structure);
rhabdomyosarcoma (cancer in the striated muscle, sometimes grows through the entire myocardium, causes symptoms of a heart attack)
fibrous cancerous histiocytoma (jelly-like oncology, characterized in that it grows into the surrounding tissues);
liposarcorm.

Other cancerous tumors are also possible, having a similar structure to the organ from which metastasis originated.

Metastases often affect the pericardial region, less often they occur in other parts of the myocardium. The manifestation of signs of heart damage depends on localization.

Causes of a malignant tumor of the heart

It is characterized by the following symptoms:

severe shortness of breath;
inflammation of the pericardium in acute form;
arrhythmic phenomena;
sharply on x-ray;
systole murmurs.

Symptoms and x-rays are not everything diagnostic methods that are used to detect heart cancer. Computed tomography and magnetic resonance imaging of the heart muscle are also used. Echocardiogram indicators are used additionally.

Most often, time is missed and an already serious stage of heart sarcoma with metastases to nearby organs, mainly the lungs and the brain, is diagnosed.

What is the treatment for a heart tumor?

Therapy Methods

In medical statistics, there is no information about the practical cure for a malignant tumor of the heart. Only palliative therapy remains.

Due to the complete damage to the organ and the developing process of metastasis, surgical intervention is excluded. Patients are prescribed chemotherapy and radiation, which will somewhat alleviate the patient's condition. There are also surgeries for heart tumors.

Treatment will have results if preventive measures are carried out, if doctors are consulted in time, examined and therapy is started in the early stages of the disease.

Need to work on strengthening immune system, because it is able to protect the body from many diseases.

Cancer cells are not brought into the body from the outside, but they are actively formed from their own cells and have a huge aggressive force of an aggressive attack on healthy cells. Immune cells receive information about foreign structures that is in transfer factors.

If these cells are small in number, the immune structures will not have sufficient information about the danger that has come. And the new cells of the immune system do not know what to do and what to protect against.

Surgery

How is a heart tumor removed? Before non-invasive cardiac imaging was developed, valvular disease was considered an indication for surgery. Since the diagnosis was uninformative.

Now, thanks to ultrasound, not a single patient with a mass in the heart has been operated on without imaging. With the help of CT and MRI, data are obtained on the characteristics of tissues and the spread of infiltration.

Medial sternotomy is a typical approach to benign tumors. At the same time, extracorporeal circulation with two-cavity drainage is connected. Calm manipulations are recommended for cardiac surgery due to the fact that most intracavitary cardiac tumors are fragile. Intraoperative transesophageal echocardiography is used, which allows you to determine what localization the tumor has, open the cavities of the heart, direct the cannula, and monitor the integrity of the tumor during surgery. A wide surgical approach is an indispensable condition for resection with one block of the tumor. The aspirated blood surrounding the tumor does not return to the extracorporeal circulation. This is necessary to prevent possible dissemination of malignant cells.

Forecast

The prognosis of the disease depends on the type of cells and the extent to which the surgical intervention was performed:

The life expectancy of cancer patients is on average from two to seven years (this is influenced by the rate of metastasis of the body and the location of new metastases).
The prognosis is influenced by donor-recipient compatibility during implantation or implantation of a donor heart. If conditions are favorable, then such patients live no more than ten years.
With benign formations and their removal, the prognosis is favorable, in 95% of cases a stable remission is observed if regular maintenance is taken. medical preparations and medical advice.

If the treatment is symptomatic, then the patient will have to live from seven months to two years.

Unfortunately, cardiac tumors are diagnosed late, when there are already serious disorders in the organ. But even if a person has been diagnosed with heart cancer, then you should not give in to despair. Survival statistics are approximate, and patients with strict adherence to medical recommendations after removal of a heart tumor can live longer than the years indicated in the prognosis.

Tumors of the heart are rare, and if a malignant neoplasm is found, then the layman will call it "heart cancer", although this is terminologically not entirely correct. Primary malignant neoplasms of the heart are sarcomas, and the cancer itself grows there from a neighboring organ or is metastatic in nature.

Tumors of the heart are represented by formations that are quite heterogeneous in nature. Their source can be the myocardium, pericardium or the inner layer of the organ, valves, partitions between the atria or ventricles, vascular system. There is no age limit when tumors occur, they can be found in the fetus, diagnosed in children, adults of young, mature or senile age. Both women and men are equally affected by them.

If neoplasias originate from the tissues of the heart itself, then they will be called primary. Such tumors make up no more than 0.2% of all neoplasms of the organ. Much more often, doctors are faced with a situation where the disease is secondary - other organs, germination of carcinomas of the lungs, stomach, esophagus, etc. Secondary tumors are up to 30 times more common than primary ones.

Regardless of the histological features and location of the tumor, all of them are fraught with heart failure, tamponade of the organ, embolism, and deadly rhythm disturbances, so even in the case of an absolutely benign neoplasm, the only treatment will be surgery, delay with which is a serious mistake.

Varieties of neoplasms of the heart

Primary tumors of the heart, growing from its structures, are:

benign;
Malignant.

Benign neoplasms account for three quarters of all cardiac tumors, and the leader among them is myxoma, which occurs in 80% of cases. The remaining 20% are also represented by formations of connective tissue origin - rhabdomyomas, vascular tumors, fibromas, pericardial cysts.

myxoma in the left atrium

Malignant neoplasms represented by sarcomas from muscle, adipose tissue, vascular walls, mesothelium covering the heart from the outside, there are neoplasias of the hematopoietic tissue -. Secondary malignant neoplasms "come" to the heart from nearby organs - the lungs, esophagus, trachea, pleura, stomach, mammary gland. In this case, cancer complexes are found that correspond in structure to those organs where they originally arose.

It is worth saying a few words about the terminology so that the reader knows why “cancer” does not grow in the heart. From the point of view of science, cancer is formed from the epithelium, and connective tissue tumors are called sarcomas. A malignant tumor of the heart is formed from muscle, fat and other types of connective tissue, therefore the term "cancer" is not used for it, but it is better to designate it as "sarcoma". If a carcinoma is found in an organ that has sprouted from other organs or appeared there as a result of metastasis, it will also not be called heart cancer, but instead they will indicate the secondary nature of the lesion, necessarily naming the primary source of cancer.

Benign neoplasms of the heart

Myxoma is the most common type of heart tumor, accounting for about half of all cases. There are several times more women among patients, the average age is 30-50 years. Atrial myxoma (most often the left one) begins its growth in the interatrial septum, fixing itself to it like a stalk and gradually filling the heart cavity. Less common are ventricular myxomas.

Myxoma looks like a spherical node of soft or dense (rarely) consistency, filling the lumen of the atrium or ventricle. The average diameter is 3-4 cm, but some myxomas can reach 8 cm, preventing blood flow and emptying of the heart chambers. Loose, lobular myxomas are very dangerous due to detachment of tumor fragments, which immediately enter the systemic circulation and can cause embolism.

Until the myxoma reaches the valvular opening or fills the chamber of the heart, its manifestations may not be. In the event of a violation of the movement of blood, overlapping of the atrioventricular valve with a hanging myxoma, symptoms appear similar to those in heart disease. Increasing violation of hemodynamics with manifestations in both circles of blood circulation.

types of benign neoplasms of the heart

Papillary fibroelastoma is the second most common after myxomas. the favorite localization of which are valves - mitral in the left and tricuspid in the right half of the heart. Outwardly, they are similar to papillomas, form papillary growths on the valve flaps, but the papillae are devoid of a vessel, unlike true papillomas. Fibroelastoma does not affect the operation of the valve leaflets, but they create big risk tumor embolism in the separation of the papillae.

Rhabdomyomas make up about a fifth of all benign heart tumors. and are especially often diagnosed in childhood. These formations grow from the striated muscle tissue of the myocardium, are located in the thickness of the heart wall (the septum and the left ventricle most often), and are prone to multiple growth simultaneously in the form of several foci. They pose a danger due to damage to conductive nerve fibers, thickening and deformation of the walls of the heart with the development of arrhythmias and organ failure.

Among the rarer varieties of benign neoplasms of the heart - fibromas, lipomas, hemangiomas, which grow both inside the myocardium or on the valves (hemangiomas, fibromas), and in cavities (lipomas). These tumors affect the conduction system, disrupt hemodynamics, and are fraught with embolism.

Video: myxoma in the program “Live great!”

Malignant neoplasms of the heart

Malignant tumors of the heart are formed from muscle, fibrous, adipose tissue, vessel walls, pericardium, and they are called. The left atrium is the most common site for growth. The disease affects young and middle-aged people.

Among sarcomas, the leading vascular tumor is angiosarcoma (up to 40% of cases). In addition to it, rhabdomyo- and leiomyosarcomas (from muscle tissue) can form within the heart, and even consisting of immature bone tissue. A quarter of all malignant neoplasias are undifferentiated sarcomas, which are prone to active growth and early metastasis and have an extremely unfavorable prognosis.

From the cells of the pericardium, it can form, more often diagnosed in men. With immunodeficiencies, including acquired ones (HIV infection), a favorable background is created for the appearance of heart lymphoma, which is growing rapidly with manifestations of organ failure, rhythm disturbances.

Manifestations of heart tumors

Most neoplasms of the heart have similar symptoms associated with the presence of additional tissue in the chamber of the organ, impaired blood flow through the valve openings, and damage to the conduction system. Clinical features are associated with the location of the tumor inside, outside the heart, in the thickness of the myocardium or on the valve leaflets. Most characteristics pathologies:

Pain and feeling of heaviness in the chest;
Dyspnea;
swelling;
Tachycardia, feeling of rhythm interruptions;
Skin cyanosis.

Malignant neoplasms tend to lead to general changes - weight loss, fever, lack of appetite, pain in the bones and joints, possibly a skin rash.

Neoplasms located outside the heart may present with shortness of breath and chest pain. As they grow, they disrupt the mobility of the organ, preventing the proper emptying and filling of its chambers. The development of cardiac tamponade, a condition in which the cavity of the heart sac is filled with blood that blocks organ contractions, is associated with possible decay and bleeding, the result of tamponade is asystole (cardiac arrest) and death.

Compression of large vascular trunks by a tumor manifests itself in the form of:

Swelling of the face and upper half of the body with compression of the superior vena cava;
Edema of the legs and venous congestion in the internal organs with compression of the inferior vena cava.

Tumors growing inside the myocardium affect the fibers of the conduction system, so heart rhythm disturbances will be the main symptoms. Patients complain of a rapid heartbeat with tachycardia, in the case of blockades, there are interruptions and a feeling of fading in the chest. In addition to arrhythmias, the phenomena of heart failure increase, shortness of breath, weakness, swelling appear, and the liver enlarges.

Tumors located inside the chambers of the heart cause a violation of blood circulation through the atria, ventricles and large vessels, prevent the filling of the heart chamber or its emptying, and can close the valve opening, imitating stenosis. The main manifestation of such tumors is considered to be rapidly progressive heart failure.

Myxoma of the left atrium when filling this chamber with itself is manifested by severe shortness of breath, fainting, chest pains. Its characteristic sign will be the increasing heart failure, not responding to conservative treatment. Possible sudden death with obstruction (closing) of the myxoma of the mitral valve. It is important that the symptoms are aggravated by changing the position of the body.

If the neoplasm affects the valves, then there are signs of their stenosis or insufficiency - stagnation in the pulmonary circulation with shortness of breath, pulmonary edema, a tendency to inflammatory processes in the respiratory system; in large - with an increase in the liver, edema, cyanosis.

Very characteristic and especially dangerous in case of valvular localization of neoplasia embolism by tumor cells. With damage to the mitral or aortic valve, cell conglomerates fall into big circle with arterial blood, clog the vessels of the heart, brain, kidneys, legs, etc. Clinically, this will manifest itself like a stroke, myocardial infarction, limb ischemia.

If tumor emboli enter the bloodstream from the right side of the heart, then the pulmonary artery and its branches become blocked, which is manifested by shortness of breath, increased pressure in the small circle, and expansion of the right half of the heart. When blood flow through the main artery is disturbed, death most often occurs from acute pulmonary heart failure.

Given the non-specificity of symptoms, which can be with a number of other heart diseases, the diagnosis of tumors of this organ is not an easy task. With the likely growth of neoplasms, it is most advisable to send the patient for ultrasound, if necessary, CT and MSCT, probing, radioisotope or radiopaque examination of the heart cavities are performed. The ECG with a tumor does not have characteristic changes; arrhythmias, conduction disturbances, signs of stress on the heart, etc., are recorded on it, which occurs with a variety of cardiac pathologies.

Treatment of heart tumors

Surgical interventions, radiation, chemotherapy are used to treat neoplasms of the heart. by the most effective method an operation is recognized, which may include the removal of a tumor located in the cavity of an organ, a section of the myocardium or pericardium with neoplasia.

In the case of myxomas and other benign tumors, surgery is the only effective method treatment. Conservative therapy relieves some of the symptoms, improves general well-being, but the risk of complications and death remains quite high, so ignoring or postponing the timing of the operation is considered a medical error.

When removing a myxoma or other benign tumor growing into the cavity of the atrium or ventricle of the heart, it is important to excise not only that part of it that creates an obstacle to blood flow, but also the site from which the neoplasm originates. This is done to reduce the likelihood of relapses, which are still diagnosed in some patients.

To access the tumor-affected heart, a median longitudinal sternotomy is used, when the incision passes through the sternum. This access provides good review for a doctor and is sufficient for manipulations on the heart and large vessels. If it is necessary to remove a tumor of the left ventricle, the surgeon penetrates there through the aorta, dissecting it transversely.

Any, including benign, tumors of the heart located in the lumen of the organ or on the valves can cause embolism, so they must be removed very carefully, without squeezing even in a single block, while the aorta must be clamped and the heart stopped. The cavities are not finger-checked; instead, they are flushed with saline to avoid leaving neoplasm cells in the heart. After heart surgery, additional plastic surgery may be required to restore the valves - prosthetics, annuloplasty.

During manipulations on the heart, it is stopped (cardioplegia) and artificial circulation is established. To maintain the myocardium for this period, pharmacological and cold “protection” is indicated - the treatment of the organ with chilled saline, the introduction of pharmacological agents into the vessels.

At malignant neoplasms attempts at radical treatment have been made, but practice has shown that a relapse occurs soon after the operation, so the main methods for such tumors are and. Often, malignant tumors are diagnosed at the stage when a significant volume of the heart and surrounding tissues is affected, so it is no longer possible to remove such a neoplasm, and the only way to help the patient is to irradiate him or prescribe systemic chemotherapy.

Such treatment is also used for secondary, metastatic, lesions of the heart. Irradiation and chemotherapy do not lead to the cessation of the tumor, but help to reduce its size, facilitating the patient's condition, so such treatment is considered palliative. In addition to reducing symptoms, palliative care can extend a patient's life up to five years from the time the disease is discovered.

The prognosis for heart tumors is serious. It can be considered favorable for benign neoplasms that were removed in a timely manner and did not lead to complications. Multiple tumors give a five-year survival rate of about 15%. With sarcomas and metastatic cancer, the prognosis is disappointing - patients die within 6-12 months from the onset of the disease, and up to 80% of patients with primary malignant neoplasia already have metastases by the time they are detected.

The author selectively answers adequate questions from readers within his competence and only within the limits of the OncoLib.ru resource. Face-to-face consultations and assistance in organizing treatment are not currently provided.

Cardiac sarcoma is a rare type of cancer that is found predominantly in young people (average age is 40 years). The prognosis for this tumor is disappointing - most patients die within a year. What is the reason for these statistics?

Sarcoma of the heart

Primary heart tumors are very rare (up to 0.5% of all types). Among them, 75% are benign, and only 25% are malignant, of which the majority are sarcomas. Sarcomas are oncological tumors originating from connective tissue.

They may occur:

on the outer surface of the heart;
inside the chambers (atria);
from muscle tissue.

Primary cardiac sarcoma develops directly from the tissues of the heart, but there are also secondary lesions of the heart with metastases from other organs. They appear the same.

Metastases in the heart and pericardium are 30 times more common than primary tumors. According to experts, 25% of patients who died from metastatic soft tissue sarcoma had cardiac metastases.

Primary cardiac sarcomas are aggressive tumors that usually do not cause symptoms until they have spread locally. Therefore, the success of treatment and the prognosis for the disease is very poor.

Fact! In addition to sarcoma, it occurs, represented mainly by adenocarcinoma.

Causes of sarcoma of the heart

The causes of heart sarcoma are unknown, but according to scientists, the following factors may affect its occurrence:

radiation;
atherosclerosis;
genetic abnormalities;
injury.

There is no 100% evidence for these factors, so nothing can be done to prevent the disease, except for periodic visits to the doctor.

Classification: types, types, forms

According to the localization of the oncological process, 2 types of heart sarcomas are distinguished:

Sarcomas right side hearts. As a rule, they have a large size and an infiltrative type of growth. They form distant and regional metastases outside the organ earlier.

Sarcomas of the left heart (left ventricle or atrium) have a solid type of growth. They metastasize later, but are often complicated by heart failure.

In the heart, there are such histological types as schwannoma.

Angiosarcomas the most common of them. They originate from the cells in the walls of blood vessels. In 80% of cases, angiosarcomas occur in the right atrium, and as they grow, they completely replace the atrial wall and fill the entire heart chamber, and can also invade adjacent structures (eg, vena cava, tricuspid valve). The development of the disease and death occur very quickly.

Rhabdomyosarcoma- the second most common primary cardiac sarcoma, which is the most common cardiac sarcoma in children. She does not have a favorite place of localization, she can affect any part of the heart. Occasionally, pericardial metastases are seen.

Leiomyosarcoma. Damages muscle fibers. May occur in vessels (superior vena cava, pulmonary artery, aorta) or in the cavities of the heart. In half of the cases they are located in the left atrium.

Mesothelioma usually originate in the visceral or parietal pericardium and may spread around the heart, compressing it. They do not invade the myocardium, but may involve the pleura or diaphragm, as mesothelioma is prone to extensive regional metastasis.

fibrosarcoma. This tumor has an infiltrative type of growth. She has no predisposition to a particular age or heart chamber. However, valvular artery involvement was observed in 50% of cases.

Malignant schwannoma- a rare type of heart cancer, originating from the tissue of peripheral nerves.

Stages and degree of malignancy of cardiac sarcoma

Knowing the stage of the disease helps the doctor decide which treatment is best and give a rough prognosis for the patient's survival. To determine the stage of sarcoma, diagnostic tests are used that specify the size and prevalence of the neoplasm at the local level and throughout the body.

These data are expressed in the following terms:

T1 Tumor size 5 cm or less:

T1a - superficial tumor;
T1b - the tumor is deep.

T2 - the size of the neoplasm exceeds 5 cm:

T2a (superficial sarcoma);
T2b (deep).

N0 - Cancer has not spread to regional lymph nodes.
N1 - the tumor has spread to regional lymph nodes.
M0 - no metastases.
M1 - there are metastases in another part of the body.

After a biopsy, they recognize the degree (indicated by the letter G), which also affects the stage. There are 3 grades for sarcoma: G1, G2 and G3.

They depend on such factors:

how different cancer cells are compared to cells of healthy tissue under a microscope;
what is the rate of cell division;
how many of them die.

The lower the combined score for these 3 factors, the lower the grade, meaning that the tumor is less aggressive and the patient's prognosis is better.

According to the listed parameters, the following stages of sarcoma are distinguished:

1 stage:

IA: T1a or T1b, N0, M0, G1;
IB: T2a or T2b, N0, M0, G1.

2 stage:

IIA: T1a or T1b, N0, M0, G2 or G3;
IIB: T2a or T2b, N0, M0, G2.

3 stage:

IIIA: T2a or T2b, N0, M0, G3;
IIIB: any T, N1, M0, any G.

Stage 4 heart sarcoma has the following indicators: any T, any N, M1 and any G.

Symptoms and signs of cardiac sarcoma

Symptoms of cardiac sarcoma depend on the location of the pathological focus. Most of them develop in the right atrium, preventing the inflow or outflow of blood.

This can cause symptoms such as:

swelling of the feet, legs, or abdomen;
swelling of the neck veins.

Angiosarcoma of the pericardium causes an increase in the amount of fluid inside the pericardium (effusion). This can affect the functioning of the heart, which is accompanied by chest pain, shortness of breath, heart palpitations, and general weakness. Ultimately, heart failure develops.

With myocardial involvement, arrhythmia and heart block often occur. The tumor can lead to angina pectoris, heart failure, heart attack.

Other symptoms of cardiac sarcoma:

hemoptysis;
violation of the heart rhythm;
dysphonia;
superior vena cava syndrome;
swelling of the face;
fever;
weight loss;
night sweats;
malaise.

An embolism can become a rare manifestation of cardiac sarcoma. This happens when pieces break off from the tumor and enter the bloodstream. They can cut off blood flow to an organ or part of the body, causing dysfunction and pain. For example, emboli that enter the brain cause stroke, and those that enter the lungs cause respiratory distress.

Diagnosis of the disease

Methods for diagnosing cardiac sarcoma vary depending on the symptoms present.

In addition to a complete medical history and physical examination, the doctor may order the following procedures:

Echocardiogram (also known as Echo). This is a non-invasive test that uses sound waves to study the movement of the heart's chambers and valves. Echocardiography is the most useful tool in diagnosing cardiac pathologies, it allows the doctor to determine the exact size and location of the tumor. More detailed pictures of the heart can be obtained using transesophageal echocardiography.
Electrocardiogram (ECG). This test records the electrical activity of the heart and shows abnormal rhythms as well as damage to the heart muscle. As a rule, on the ECG there are signs such as right ventricular hypertrophy, atrial fibrillation, paroxysmal atrial tachycardia.
Computed tomography (CT). Diagnostic procedure imaging, which uses a combination of x-rays and computer technology to produce horizontal or axial images (often called slices) of the body. A CT scan provides detailed images of any part of the body. It is used to clarify the size, location of the tumor, as well as its metastases.
Magnetic resonance imaging (MRI). This procedure uses a combination of large magnets and a computer to obtain detailed images of the organs and structures of the body. MRI can be used if you need to clarify some details that are not visible on CT and Echo.
radiograph chest(used to detect heart enlargement, pleural effusion, heart failure and other pathologies).
Biopsy (removal of a small amount of tumor tissue for examination under a microscope). A biopsy is the only way to know for sure the type and malignancy of a tumor.

Treatment of cardiac sarcoma

The type of treatment for cardiac sarcoma largely depends on its location and size, as well as the degree of metastasis. If possible, the tumor is subjected to surgical resection. Together with it, the affected part of the organ is removed, and then reconstruction is carried out using the pig's pericardium, synthetic materials or prostheses.

Due to the fact that oncology is often found on late stages operation is limited. Complete resection is possible in 55% of cases when the neoplasm is limited to the atrial septum, a small part of the ventricle or valve.

Partial removal of the sarcoma does not cure the disease, but it is used to relieve symptoms or confirm the diagnosis (biopsy). Mortality during surgery for cardiac sarcoma is high, although acceptable - about 8.3%.

Currently, many centers use the endoscopic method of removing tumors from the left atrium, which gives good results. Usually, these operations are not preceded by a biopsy and a histological assessment of malignancy, but do it after.

Chemotherapy and radiotherapy

Due to the rarity of these tumors and the lack of extensive research, there is no single approach to treating patients, and the benefits of adjuvant chemotherapy and radiotherapy are unclear.

Many researchers emphasize the superiority of combination therapy, which helps to achieve twice the life expectancy (median survival was 24 months compared to 10 months). But this can only be achieved in patients with primary radical resection.

Other sources indicate that the use of neoadjuvant chemotherapy is advisable in the treatment of right heart sarcomas, since it allows to reduce the size of the neoplasm and increase the likelihood of total resection.

Due to the fact that pathologies of the left heart often lead to heart failure, neoadjuvant chemotherapy is contraindicated for them. In such situations, it is better to perform a complete surgical resection, but this anatomical location makes the operation extremely difficult. Therefore, it should be carried out by highly qualified doctors.

The role of radiotherapy also remains unproven, although it has been used to treat residual tumor (after partial resection), as well as for local or distant recurrences.

In the presence of multiple metastases, chemotherapy and radiation help to alleviate the symptoms of the disease and improve the patient's quality of life.

Other treatments

The modern approach to the treatment of sarcoma involves the use of targeted (targeted) therapy. It includes anti-angiogenic drugs that can inhibit the amount of angiogenic proteins: Sunitinib, Sorafenib. Targeted therapy is particularly effective in tumors of vascular etiology, such as angiosarcoma. Targeted drugs lead to a decrease in the volume of the neoplasm and stop its growth. They can be combined with cytostatics.

For extensive lesions that cannot be completely removed, a heart transplant is suggested. After such an operation, the patient must receive immunosuppressants (drugs that help prevent the rejection of foreign tissue), and these can stimulate new growth of the sarcoma. Therefore, the technique of autotransplantation is now actively developing.

Autotransplantation is a surgical procedure in which the patient's own heart is removed, after which the tumor is cut out of it. During the operation, the patient is placed on a heart-lung machine. After removal of the sarcoma, the heart is returned to its place. This does not require the subsequent appointment of immunosuppressants.

Metastases and recurrence

Up to 80% of patients at the time of diagnosis have metastases of cardiac sarcoma (often in the lungs). New foci of the disease can occur even after the radical removal of the neoplasm.

Due to frequent relapses, such a low survival rate of patients is observed. The highest risk of disease progression was noted in the first 2 years after surgery. Used to treat recurrent cardiac sarcoma radiation therapy with a total focal dose of not more than 65 g, targeted, as well as non-adjuvant chemotherapy.

It is noteworthy that not distant metastases, but local progression, has long been recognized as the main cause of death in patients.

How long do patients with cardiac sarcoma live?

The prognosis for cardiac sarcoma depends on the completeness of surgical resection, the location of the tumor and its histological type, as well as the degree of myocardial involvement.

One study found that the median survival after radical operation is 24 months, compared with 10 months that patients live after partial removal of the tumor.

A case of long-term survival of 10 years after complete removal left atrial rhabdomyosarcoma.

Factors that improve survival are:

sarcoma of the left-sided type;
mitotic rate less than 10 in a high power field;
no necrosis on histology.

Most patients eventually die from metastases or heart failure.

Informative video:

Among malignant tumors internal organs, the heart muscle is rarely exposed to this terrible disease. Obviously, this is due to the fact that in the human body, blood nourishes the heart much better than other organs. Here, metabolic processes take place faster, which means that the protective reaction is much stronger.

The tumor of the heart has a primary form and a secondary one. The first includes benign and malignant tumors. The second group includes all metastasized cancer cells that are delivered to the heart muscle through the bloodstream and lymphatic pathways from the affected organs.

Malignant tumor and causes

Heart cancer, as a primary tumor, develops directly from the tissues of the heart muscle itself. But this rarely happens.

The secondary form of malignant disease is much more common. With the flow of blood, cancer cells from the affected organs enter the heart. This connection of cell transfer occurs due to the alignment of cardio-vascular system passing throughout the body, which facilitates the path of metastases.

Malignant tumors localized in organs gastrointestinal tract, the pelvic organs are capable of a rapid uncontrolled process of division of the affected cells.

Thus, metastases quickly reach new targets, including affecting the heart.

To date, the direct causes of damage to the heart muscle by an oncological disease have not been fully elucidated, but possible ones include:

muscle surgery due to injury;
blood clots;
atherosclerotic processes in the brain and in the vascular system;
hereditary predisposition by genotype;
Constant stressful conditions and experiences weaken the body and undermine the immune system.

Varieties of primary formations

The most common benign neoplasms include:

Rhabdomyoma - develops in the muscle tissue of the heart;
Fibroma - grows from fibrous cells;
Lipoma - occurs in the cells of the adipose tissue of the body;
Myxoma - occurs in 55% of heart muscle cancers.

The malignant form is represented by only two varieties:

sarcoma of the heart;
lymphoma.

Cardiac sarcoma is more common than lymphoma. It affects the disease of a person in middle age. Among this disease there are angiosarcomas, undifferentiated sarcomas, malignant fibrous histiocytomas, leiomyosarcomas.

Hit, mostly left atrium, suffers mitral orifice due to tissue compression by the tumor. As a rule, heart failure sets in, extensive metastases spread to the lungs.

Mesothelioma occurs in men, although rarely. With this tumor, metastases spread to the spine, brain, nearby soft tissues.

Clinical picture

The danger is that heart cancer at the beginning of the disease is asymptomatic. The patient may not be aware that he has this cancer. Some common signs ailments, which include:

subfebrile periodic temperature;
weakness and fatigue;
pain in the joints;
sudden unexplained weight loss.

Such signs are inherent in many diseases, therefore they can confuse the sick person and delay his appeal to a cardiologist or oncologist.

Even specialists without a special examination often cannot immediately understand the diagnosis.

More accurate symptoms of the disease depend on the location of the malignant tumor in the heart muscle, the history of its occurrence, the definition of primary or secondary origin.

Neoplasm diagnostics

The following symptoms most accurately characterize the neoplasm:

the heart muscle on ultrasound is enlarged in size;
concerned about pain in the sternum and heart;
persistent arrhythmia;
compression of a growing tumor of the vena cava, which can cause swelling, pain, shortness of breath;
cardiac tamponade, manifested by a decrease in stroke volumes of the heart muscle; accumulation of fluid between the sheets of the pericardium;
thickened fingers;

Neoplasms of the heart

the appearance of puffiness and swelling on the face;
causeless rashes on various areas of the body;
feeling of numbness in the fingers;
swelling in the lower extremities;
fainting, dizziness, headaches.

The contractility of the heart is often weakened, as a result of what is happening, the rapid development of heart failure begins. The patient begins to suffer from signs of suffocation.

Naturally, such a condition worsens the course of the disease and there are fewer and fewer opportunities for a happy cure. A special place is given to the presence of metastatic symptoms.

Malignant cells metastasize from regional organs affected by oncology - the thyroid gland, the tops of the lungs, the kidneys and the mammary gland in women.

Such consequences await the heart muscle in case of damage to blood cancer, lymphomas and melanomas. The pericardium, which is one of the membranes of the heart, joins the rapidly developing heart cancer.

You can diagnose by the corresponding symptoms:

severe shortness of breath;
observation of the pericardium in an acute form;
arrhythmic phenomena;
the contours of a sharply enlarged heart are visible on the x-ray;
systole sounds are heard.

In addition to symptoms and x-rays, diagnostics is used CT scan and magnetic resonance imaging of the heart muscle. Additionally, echocardiogram indicators are used.

Most often, time is missed and a serious stage of heart sarcoma and its metastases to nearby organs, primarily the brain and lungs, are diagnosed.

Treatment

Medical statistics do not know a practical cure for a malignant tumor of this organ. More often it is a palliative method of treatment.

Surgical intervention is excluded due to the developing process of metastases and complete damage to the organ. Patients are prescribed chemotherapy, radiation, which should alleviate the patient's condition.

Treatment will have results if carried out preventive actions, contact a cardiologist in time, undergo an examination and begin treatment at an early stage of the disease.

It is necessary to strengthen the body's immune system, which is able to protect the body from many diseases.

Despite the fact that cancer cells are not introduced into the body from the outside, they are actively dividing from our own cells and endowed with a huge force of aggressive attack on healthy cells. Immune cells receive information about foreign structures, which is in the transfer factors.

With small amounts of these cells, the immune structures do not receive sufficient information about the danger that has come upon the body. Renewed cells of the immune system do not know what they need to do and protect.

A tumor in the heart is any type of abnormally growing tissue, either malignant or benign. Due to the functional characteristics of the organ, this condition is often fatal even in a non-cancerous course. Basically, the signs of pathology develop suddenly and resemble manifestations of other diseases.

Tumor processes affect the following departments:
epicardium (sheath of tissues that covers the organ);

myocardium (muscle walls);

endocardium (inner lining of the heart cavity).

Primary tumors of the heart are rare, affecting 1 in 2,000 people. Often, tumors that start elsewhere in the body spread to the heart and are secondary. A non-cancerous primary tumor, or myxoma, develops in the left atrium and is more common among women.
The main benign types include:

Myxomas are the most common neoplasms within an organ. They occur in every fifth episode of detection of a tumor in the heart and most often affect the left chamber of the organ.

Rhabdomyomas develop in the myocardium or endocardium and are also detected in one in five cases of diagnosis. Often formed in infants against the background of tuberous sclerosis adenomas sebaceous glands, kidney tumors and arrhythmias. Usually formations appear inside the ventricular walls.

Fibromas that are found in the myocardium or endocardium, affecting the valves of the heart. Often accompanied by an inflammatory process.

Teratomas of the pericardium are fixed at the bases of large vessels. They are predominantly found in newborns, but are less common than cysts or lipomas. They are asymptomatic and are detected by chest x-ray. Surgical intervention carried out to exclude the risk of other pathologies. Benign tumors of the heart grow slowly, may not change for years.

Malignant foci are reborn from any tissue of the heart and often occur in children. Formations that grow quickly and aggressively are divided into five groups:
Angiosarcomas account for about a third of all malignant tumors affecting the right atrium and ventricle.

Fibrosarcomas are localized in the atria and account for up to 5% of cancers in the heart.

Rhabdomyosarcomas are formed in striated muscle tissue, appear at any age, more often in males.

Liposarcomas are soft foci of lipoblasts in the left atrium, mimicking myxomas.

Synovial sarcomas are found in the atria and pericardium. Often these are primary formations, unwilling to grow.

In most cases, malignant tumors on the heart are secondary and migrate from other organs and systems. Carcinomas, sarcomas, leukemias, and reticuloendothelial tumors grow in any part of the heart. Often they appear against the background of breast and lung cancer. Malignant melanomas often affect the heart.
The expression of genes that provoke tumor processes is influenced by toxins from food, which more often accumulate in adipose tissue. The heart, located in the pericardium, is protected from cancer by the muscular structure and fluid filling of the membrane.

Primary benign heart tumors and their symptoms
Symptoms of a heart tumor indicate the area of the lesion. In malignant processes, neoplasms are manifested by signs cardiovascular disease which usually confirms the presence of metastases. The classification distinguishes three types of tumors, the manifestations of which are due to localization:
Extracardiac neoplasms are expressed by an increase in body temperature, joint pain and weight loss, chills and rash. compression of the chambers of the heart and coronary arteries provokes shortness of breath and pain in the sternum. With the growth and rupture of foci, tamponade develops.

Intramyocardial (rhabdomyomas, fibromas) put pressure on the conduction system, cause atrioventricular or intraventricular blockades, tachycardia attacks.

Intracavitary ones interfere with the operation of valves and the passage of blood, are manifested by stenosis of the mitral and tricuspid valves, heart failure, which increases with a change in body position.

The first signals may be thromboembolism, which are divided into right- and left-sided:

damage to the right departments causes pulmonary hypertension and cor pulmonale;

damage to the left departments - cerebral ischemia, strokes and heart attacks.

Myxoma is distinguished by three specific features:
Symptoms that mimic bacterial endocarditis and collagen vascular disease without clinical evidence of malignancy.

Embolic signs appear when fragments of tumors break off and enter the bloodstream, which provokes thrombosis.

Blockage of blood flow occurs when any valve of the heart opens, most often the mitral valve.

General clinical symptoms are observed in 90% of cases:

increasing weakness;

inability to perform the usual load;

poor appetite;

pain in the joints;

temperature increase.

Blood test shows hemolytic anemia, increased levels of immunoglobulins and inflammatory process. The increase in shortness of breath corresponds to blockage of the pulmonary trunk by a thrombus, but the signs disappear in the supine position.
A tumor located in the epicardium affects the functioning of the valves, causing a heart murmur. If the sounds depend on the position of the body, this means a non-true valvular problem. There is no compensatory enlargement of the left atrium.
Fibromas on x-ray photos have clear boundaries, which is important diagnostic criterion. Cavitary formation in the left ventricle is characterized by calcification. Fibroma provokes arrhythmias, heart failure, pericarditis and hypertrophic cardiomyopathy, hemangiomas. When formations appear in the interventricular septum, the risk of death increases. Fibromas are more common in children under 10 years of age.
Rhabdomyomas are intramuscular tumors that are found in babies by chance. They are associated with the accumulation of glycogen and can disrupt the contraction of the ventricles. With the depletion of the specified polysaccharide, the tumors regress.
Symptoms of cardiac rhabdomyoma include:
ischemia;

tachycardia;

an increase in the size of the heart;

signs of blockage of the blood duct from the ventricles;

murmurs in the heart.

When symptoms appear against the background of tuberous sclerosis, a benign character is assumed. If there are multiple nodules surgery not carried out.
Papillary fibroelastoma of the heart appears at any age, but people over 60 are more susceptible to it. Tumors are located on the mitral or aortic valve, behave secretly, without symptoms.

Symptoms of malignant neoplasms
Compared to benign tumors, malignant ones provoke a more severe and rapid deterioration in well-being, can spread to the spine, nearby soft tissues and vital organs.
Symptoms of cancers that start directly in the heart include:
sudden heart failure;

accumulation of fluid in the mucous membrane of the main organ during blockage of blood flow;

various arrhythmias.

If the formation has spread from another part of the body, then the diagnosis fixes:
a rapid increase in the heart, a change in shape on an x-ray;

heart rhythm disturbances;

heart failure for no reason.

Most infants with tumors found in the hospital usually do not survive past their first year.
Diagnostics
If heart tumors are suspected, a hereditary predisposition to the disease is studied. Myxomas have a partially genetic basis. The presence of a malignant focus in another part of the body may indicate heart problems caused by metastases. Myxomas are diagnosed based on symptoms, echocardiogram results. Computed and magnetic tomography is used, less often - angiocardiography. Sometimes cardiac catheterization, biopsy of the myocardium and endocardium is required. Right atrial myxomas may be atrial and contain calcium deposits that are visible on a chest x-ray.
To identify rhabdomyoma and fibroma, it is enough to ask the patient about the symptoms. In the presence of heart attacks and tuberous sclerosis, a benign formation should be suspected. The diagnosis is confirmed by means of echocardiography and angiocardiography.

Treatment and prognosis
Benign heart tumors that go untreated can be life-threatening. Myxomas are most often removed surgically, and multiple nodules, rhabdomyomas, and fibromas are usually left alone.
Cancer treatment includes radiation and chemotherapy, as well as symptomatic therapy complications. The prognosis is usually poor.
To reduce the risk of developing and growing tumors, you need to:
stop smoking;

reduce the amount of alcohol;

avoid exposure to solar radiation.

Screening with a blood test detects tumors in the early stages when they are curable. Tests also include mammography for the breast, cytology for cervical cancer, and colonoscopy for colon lesions.
Patients with heart murmurs and arrhythmias should undergo a comprehensive evaluation. In the presence of oncological diseases and heart attacks, a secondary tumor can also be suspected.
The following procedures are performed during the diagnostic process.