Malignant primary cardiac tumors. The Cleveland Clinic experience, 1956 to 1986

Our plain-English summary of Malignant primary cardiac tumors. The Cleveland Clinic experience, 1956 to 1986, by P.A. Bear, D.S. Moodie (Chest, 1987).

The study

• Authors: P.A. Bear, D.S. Moodie
• Journal: Chest
• Published: 1987;92(5):860-2
• Cited by: 77 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant primary cardiac tumors have uniformly been associated with poor long-term survival. We reviewed data on 11 patients with such tumors seen between 1956 and 1986. There were five men and six women, with a mean age at presentation of 44 years. Nine (82 percent) of 11 patients presented initially with respiratory symptoms, and 45 percent (five) presented with chest pain. No patient was asymptomatic on initial presentation. Forty-five percent (five) of the patients had elevated jugular venous pressure or a systolic murmur. Cardiomegaly was present in eight (73 percent) of 11 patients. Nine of ten patients had a hemoglobin level less than 12 g/100 ml, and 30 percent (3/10) presented with thrombocytosis. Seventy percent (eight) of the patients underwent surgical biopsy, and in 30 percent (three), surgical excision of the tumor was attempted. Angiosarcoma was the most frequent type of tumor (four patients), followed by malignant fibrous histiocytoma (three patients), mesothelioma (two patients), rhabdomyosarcoma (one patient), and primary lymphoma (one patient). Long-term follow-up data reveals that ten (91 percent) of 11 patients had died, with a mean duration from diagnosis until death of 9.7 months. Newer pathologic techniques for identification of sarcomas, aggressive surgical resection, and advanced chemotherapy for certain subgroups may contribute to better survival for patients with these tumors in the future. In addition, cardiac transplantation may play an important role in the future for those patients with localized disease.

In plain English

This was a retrospective review of the 11 patients diagnosed with malignant tumors arising in the heart at the Cleveland Clinic Foundation between 1956 and 1986 (six women, five men; mean age 44). Angiosarcoma was most frequent (four patients), followed by malignant fibrous histiocytoma (three), mesothelioma (two), rhabdomyosarcoma (one) and primary lymphoma (one). One mesothelioma was in the right atrium and one in the pericardium, the sac around the heart. The article does not mention asbestos or any other exposure. Nine of 11 patients first had breathing symptoms. Ten had some surgical procedure, and full tumor removal was attempted in three. Ten of the 11 died. The only survivor had a primary lymphoma treated with radiation. The mean time from diagnosis to death is given as nine months in the main text and 9.7 months in the article's abstract. The authors concluded that newer pathology techniques, aggressive surgery and advanced chemotherapy for some subgroups may improve survival, and that heart transplantation may help some patients with localized disease.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: retrospective case series from a single institution
• Who was studied: 11 patients with malignant primary cardiac tumors seen at the Cleveland Clinic Foundation, 1956 to 1986: six women and five men, mean age 44 at presentation
• Main results:
  • Tumor types among the 11 patients: angiosarcoma in four, malignant fibrous histiocytoma in three, mesothelioma in two, rhabdomyosarcoma in one, primary lymphoma in one
  • Of the two mesotheliomas, the table lists one in the right atrium (patient 8, a 33-year-old woman) and one in the pericardium (patient 9, a 29-year-old man, described as mesothelioma of pericardium)
  • Nine of the 11 patients first presented with respiratory symptoms
  • Ten of the 11 patients had some form of surgical procedure. Total excision of the tumor was attempted in three.
  • According to the article's abstract, 10 of the 11 patients died, with a mean time from diagnosis to death of 9.7 months
  • According to the main text, there was one survivor and the mean time from diagnosis to death was nine months
  • The survivor (patient 11, primary lymphoma of the heart) received radiation therapy and was alive and well five years after diagnosis
  • The authors reported that chemotherapy or radiation after surgery had little effect on survival, apart from patient 11
• The authors' conclusion: The authors concluded that newer pathologic techniques for identifying sarcomas, aggressive surgical resection, and advanced chemotherapy for certain subgroups may contribute to better survival in the future. They also concluded that cardiac transplantation may play a role for patients with localized disease.

Topics

Medical terms in this study, explained in our Lexicon: Biopsy, Mesothelioma, Sarcoma, Surgical Resection, Chemotherapy.

Related studies

• Primary cardiac tumors: experience at the University of Minnesota — J.E. Molina, J.E. Edwards, et al. (1990)
• Surgical pathology of primary cardiac and pericardial tumors — C. Basso, M. Valente, et al. (1997)
• Cardiac tamponade as the initial manifestation of primary pericardial mesothelioma — M. Stein, A. Neuman, et al. (1995)
• Occult primary cardiac lymphomas causing unexpected/sudden death or acute heart failure — A. De Martino, F. Del Re, et al. (2020)
• Sarcomatoid Type Primary Pericardial Mesothelioma with a Long-term Survival after the Onset of Cardiac Tamponade — C. Saisho, H. Ishii, et al. (2016)
• Cardiac tumors that cause arrhythmias — K.F. Kusano, T. Ohe (2002)

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