A Comprehensive Review of Cardiac Tumors: Imaging, Pathology, Treatment, and Challenges in the Third Millennium

Cardiac tumors represent rare neoplasms, but they include a very wide range of neoplasia—first primary benign and malignant cardiac tumors, then cardiac metastases, with these latter ones being far more common in adulthood. These diagnoses may be challenging because of frequently non-specific signs...

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Main Authors: Andrea De Martino, Claudia Pattuzzi, Sara Garis, Francesca Bosco, Vittorio Maria Virgone, Antonio Salsano, Francesco Santini, Angela Pucci
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/11/1390
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author Andrea De Martino
Claudia Pattuzzi
Sara Garis
Francesca Bosco
Vittorio Maria Virgone
Antonio Salsano
Francesco Santini
Angela Pucci
author_facet Andrea De Martino
Claudia Pattuzzi
Sara Garis
Francesca Bosco
Vittorio Maria Virgone
Antonio Salsano
Francesco Santini
Angela Pucci
author_sort Andrea De Martino
collection DOAJ
description Cardiac tumors represent rare neoplasms, but they include a very wide range of neoplasia—first primary benign and malignant cardiac tumors, then cardiac metastases, with these latter ones being far more common in adulthood. These diagnoses may be challenging because of frequently non-specific signs and symptoms; for example, their clinical management may be difficult because of the site and because of possible hemodynamic or arrhythmogenic consequences, independent from their biology. Cardiac tumors may be asymptomatic and incidentally diagnosed, or they may cause heart failure, life-threatening arrhythmias, or even sudden cardiac death. Although they may still represent a post-mortem finding, the evolution and the larger use of cardiac imaging tools, initially echocardiography, has progressively and significantly increased their in vivo detection. Magnetic resonance imaging and computed tomography may give crucial information as to the composition and localization of cardiac masses, useful for investigating them and for planning surgery. Histology is mandatory for the definite and differential diagnosis of the cardiac masses, for assessing predictive factors in malignancies, and for then establishing the appropriate management of patients. Modern techniques applied to histology, including immunohistochemistry and molecular biology, may be required to characterize cardiac tumors, to properly classify them and to assess predictive and/or prognostic markers. Surgical procedures, including minimally invasive surgery, have also dramatically evolved in the last decades, allowing adequate treatment in most cardiac tumors. Finally, biopsy may be useful in selected cases, particularly when radical surgery is not feasible, and histological diagnosis is fundamental for other possible therapeutic approaches. The scope of this review covers advancements in the imaging diagnosis, histology, and treatment of primary and secondary cardiac tumors.
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spelling doaj-art-fb2d60dc56984e88acf3a5a049f870cd2025-08-20T03:46:52ZengMDPI AGDiagnostics2075-44182025-05-011511139010.3390/diagnostics15111390A Comprehensive Review of Cardiac Tumors: Imaging, Pathology, Treatment, and Challenges in the Third MillenniumAndrea De Martino0Claudia Pattuzzi1Sara Garis2Francesca Bosco3Vittorio Maria Virgone4Antonio Salsano5Francesco Santini6Angela Pucci7Division of Cardiac Surgery, Ospedale Policlinico San Martino, 16132 Genoa, ItalyDivision of Cardiac Surgery, Ospedale Policlinico San Martino, 16132 Genoa, ItalyDivision of Cardiac Surgery, Ospedale Policlinico San Martino, 16132 Genoa, ItalyHistopathology Department, Pisa University Hospital, 56100 Pisa, ItalyHistopathology Department, Pisa University Hospital, 56100 Pisa, ItalyDivision of Cardiac Surgery, Ospedale Policlinico San Martino, 16132 Genoa, ItalyDivision of Cardiac Surgery, Ospedale Policlinico San Martino, 16132 Genoa, ItalyHistopathology Department, Pisa University Hospital, 56100 Pisa, ItalyCardiac tumors represent rare neoplasms, but they include a very wide range of neoplasia—first primary benign and malignant cardiac tumors, then cardiac metastases, with these latter ones being far more common in adulthood. These diagnoses may be challenging because of frequently non-specific signs and symptoms; for example, their clinical management may be difficult because of the site and because of possible hemodynamic or arrhythmogenic consequences, independent from their biology. Cardiac tumors may be asymptomatic and incidentally diagnosed, or they may cause heart failure, life-threatening arrhythmias, or even sudden cardiac death. Although they may still represent a post-mortem finding, the evolution and the larger use of cardiac imaging tools, initially echocardiography, has progressively and significantly increased their in vivo detection. Magnetic resonance imaging and computed tomography may give crucial information as to the composition and localization of cardiac masses, useful for investigating them and for planning surgery. Histology is mandatory for the definite and differential diagnosis of the cardiac masses, for assessing predictive factors in malignancies, and for then establishing the appropriate management of patients. Modern techniques applied to histology, including immunohistochemistry and molecular biology, may be required to characterize cardiac tumors, to properly classify them and to assess predictive and/or prognostic markers. Surgical procedures, including minimally invasive surgery, have also dramatically evolved in the last decades, allowing adequate treatment in most cardiac tumors. Finally, biopsy may be useful in selected cases, particularly when radical surgery is not feasible, and histological diagnosis is fundamental for other possible therapeutic approaches. The scope of this review covers advancements in the imaging diagnosis, histology, and treatment of primary and secondary cardiac tumors.https://www.mdpi.com/2075-4418/15/11/1390cardiac tumorsheart massespericardial tumorshistologycardiac surgeryrare neoplasms
spellingShingle Andrea De Martino
Claudia Pattuzzi
Sara Garis
Francesca Bosco
Vittorio Maria Virgone
Antonio Salsano
Francesco Santini
Angela Pucci
A Comprehensive Review of Cardiac Tumors: Imaging, Pathology, Treatment, and Challenges in the Third Millennium
Diagnostics
cardiac tumors
heart masses
pericardial tumors
histology
cardiac surgery
rare neoplasms
title A Comprehensive Review of Cardiac Tumors: Imaging, Pathology, Treatment, and Challenges in the Third Millennium
title_full A Comprehensive Review of Cardiac Tumors: Imaging, Pathology, Treatment, and Challenges in the Third Millennium
title_fullStr A Comprehensive Review of Cardiac Tumors: Imaging, Pathology, Treatment, and Challenges in the Third Millennium
title_full_unstemmed A Comprehensive Review of Cardiac Tumors: Imaging, Pathology, Treatment, and Challenges in the Third Millennium
title_short A Comprehensive Review of Cardiac Tumors: Imaging, Pathology, Treatment, and Challenges in the Third Millennium
title_sort comprehensive review of cardiac tumors imaging pathology treatment and challenges in the third millennium
topic cardiac tumors
heart masses
pericardial tumors
histology
cardiac surgery
rare neoplasms
url https://www.mdpi.com/2075-4418/15/11/1390
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