Heart cancer (primary cardiac tumor) is cancer that arises in the heart. Cancerous tumors that begin in the heart are typically sarcomas, a type of cancer that originates in the soft tissues of the body. A malignancy of the heart can grow in any of the four chambers, on the inside surface, on the outer surface, and anywhere in between. Only 0.00138 percent of the general population or 1.38 out of 100,000 individuals will experience heart cancer. It is the high prevalence of cancer in epithelial tissue rather than connective tissue, and the fact the cells of the heart do not undergo cell division that causes heart cancer to be rare.
The majority of primary cardiac sarcomas fall into the specification of angiosarcomas and tend to develop in the right atrium of the affected individual’s heart. The most common type of malignancy that occurs in the left atrium of the heart includes leiomyosarcoma and pleomorphic sarcoma. Sarcomas that develop in the left atrium tend to be a more condensed type of tumor that does not infiltrate surrounding tissues as quickly as other types of heart cancer. Cardiac tumors that develop in the right side of an affected individual’s heart tend to take on a bulkier appearance and grow in an outward direction, infiltrating the tissues around it.
Most cancers found in the heart are secondary tumors that have metastasized from elsewhere in the body. Cancers that begin near the heart, such as lung cancer, can grow to involve the heart or the lining around the heart (pericardial sac). According to the Mayo Clinic, cancers that may affect the heart include breast cancer, kidney cancer, lung cancer, leukemia, lymphoma and melanoma, among others.
There is a rare type of cancer, known as carcinoid tumor, that may produce hormones that can damage heart valves.
Symptoms of a primary heart tumor most often occur with a change of body position and may include:
- Difficulty breathing when lying flat or when asleep.
- Fainting, lightheadedness or dizziness.
- Palpitations or rapid heart rate.
- Chest pain or tightness in the chest.
In addition, symptoms can occur in heart cancer related to emboli or small parts of the tumor that become loose.
- Sharp chest pain.
- Irregular heartbeat.
- Facial droop.
- Problems with speech and comprehension.
- Cold limb with no pulse.
Some other nonspecific symptoms known to manifest with heart cancer include:
- Fever.
- Night sweats.
- Joint pain.
- Chills.
- Weight loss.
Urgent surgical treatment is indicated for all cardiac tumors, malignant or benign, because of the high risk of secondary complications. Removal requires open heart surgery. Most of the time this the surgery can be done robotically or using a minimally invasive technique.
Tumors in the region of the atria or atrioventricular valves may restrict the blood flow into the heart, mimicking stenosis of the mitral or tricuspid valve. Mobile, pediculated neoplasms generally lead to paroxysmal heart failure or dyspnea, depending on posture. Tumor infiltration into the wall of the heart may produce the symptoms of hypertrophic or restrictive cardiomyopathy. The clinical presentation is dominated by heart failure. Expansion into the superior vena cava may result in superior vena cava syndrome. Tumor infiltration of the neural pathways or the myocardium can cause irregular heartbeat and especially AV block. This is particularly true for fibromas.