Differential Diagnosis of Cardiac Tumors: General Consideration and Echocardiographic Approach

Overview

Journal J Clin Ultrasound

Specialty Radiology

Date 2022 Oct 11

PMID 36218203

Authors

Paolo G Pino

Antonella Moreo

Chiara Lestuzzi

Affiliations

Soon will be listed here.

Abstract

Cardiac tumors may be primary (either benign or malignant) or secondary (malignant) and are first detected by echocardiography in most cases. The cardiologist often challenges their identification, the differential diagnosis and the best therapeutic approach. Malignant tumors have usually a poor prognosis, which may be significantly improved by appropriate and timely therapies. The echocardiographic aspects of benign and malignant cardiac tumors described in this article, along with a clinical evaluation may orient the differential diagnosis and aid in choosing the further steps useful to define the nature of the mass.

Citing Articles

Cardiac Metastasis: Epidemiology, Pathophysiology, and Clinical Management.

Luca F, Parrini I, Canale M, Rao C, Nucara M, Pelaggi G Life (Basel). 2025; 15(2).

PMID: 40003702 PMC: 11857090. DOI: 10.3390/life15020291.

Cardiac Tumors Causing Sudden Cardiac Death: A State-of-the-Art Review in Pathology.

Salzillo C, Luca S, Ronchi A, Franco R, Iacobellis G, Leggio A Cancers (Basel). 2025; 17(4).

PMID: 40002264 PMC: 11853695. DOI: 10.3390/cancers17040669.

Primary Cardiac Diffuse Large B-Cell Lymphoma: Diagnostic Journey of Undifferentiated Right Atrial Mass.

Dhingra N, Nyamande D, Alhothali A, Ghunaim A, Cusimano R JACC Case Rep. 2025; 29(24):102924.

PMID: 39822617 PMC: 11734134. DOI: 10.1016/j.jaccas.2024.102924.

Cardiac Tumor Within the Left Ventricle: Thrombus or Something Else?.

Barron K, Landrum A, Abu Daya H, Clarkson S JACC Case Rep. 2024; 29(23):102719.

PMID: 39691347 PMC: 11646900. DOI: 10.1016/j.jaccas.2024.102719.

A Cardiac Tumor and Liver Masses on Point of Care Ultrasound (POCUS): Implications in a Resource-Limited Setting.

Sous W, Limwado G, Ndarama E, Sous M POCUS J. 2024; 9(2):18-21.

PMID: 39634679 PMC: 11616798. DOI: 10.24908/pocus.v9i2.17665.

References

Lepper W, Shivalkar B, Rinkevich D, Belcik T, Wei K . Assessment of the vascularity of a left ventricular mass using myocardial contrast echocardiography. J Am Soc Echocardiogr. 2002; 15(11):1419-22. DOI: 10.1067/mje.2002.124641. View

Hari P, Mohamad T, Kondur A, Jahania S, Afonso L . Incremental value of contrast echocardiography in the diagnosis of atrial myxoma. Echocardiography. 2010; 27(5):E46-9. DOI: 10.1111/j.1540-8175.2009.01128.x. View

De Filippo M, Chernyschova N, Maffei E, Rovani C, De Blasi M, Beghi C . Primary cardiac Burkett's type lymphoma: transthoracic echocardiography, multidetector computed tomography and magnetic resonance findings. Acta Radiol. 2006; 47(2):167-71. DOI: 10.1080/02841850500466559. View

Yanagawa B, Chan E, Cusimano R, Reardon M . Approach to Surgery for Cardiac Tumors: Primary Simple, Primary Complex, and Secondary. Cardiol Clin. 2019; 37(4):525-531. DOI: 10.1016/j.ccl.2019.07.001. View

Lacerda Q, Tantawi M, Leeper D, Wheatley M, Eisenbrey J . Emerging Applications of Ultrasound-Contrast Agents in Radiation Therapy. Ultrasound Med Biol. 2021; 47(6):1465-1474. PMC: 8044052. DOI: 10.1016/j.ultrasmedbio.2021.01.032. View

Samanidis G, Khoury M, Balanika M, Perrea D . Current challenges in the diagnosis and treatment of cardiac myxoma. Kardiol Pol. 2020; 78(4):269-277. DOI: 10.33963/KP.15254. View

Koh T . Invasion of lung mesenchymal chondrosarcoma into the left atrium via the pulmonary vein detected on transoesophageal echocardiography. Eur J Echocardiogr. 2011; 12(7):556. DOI: 10.1093/ejechocard/jer068. View

Duyuler S, Demirkan B, Guray Y, Demir C, Guray U . Echocardiography in differential diagnosis of chest pain and elevated cardiac biomarkers: a case of cardiac angiosarcoma. Eur J Echocardiogr. 2011; 12(5):406-7. DOI: 10.1093/ejechocard/jer030. View

Mas C, Penny D, Menahem S . Pre-excitation syndrome secondary to cardiac rhabdomyomas in tuberous sclerosis. J Paediatr Child Health. 2000; 36(1):84-6. DOI: 10.1046/j.1440-1754.2000.00443.x. View

10.

Aggeli C, Dimitroglou Y, Raftopoulos L, Sarri G, Mavrogeni S, Wong J . Cardiac Masses: The Role of Cardiovascular Imaging in the Differential Diagnosis. Diagnostics (Basel). 2020; 10(12). PMC: 7765127. DOI: 10.3390/diagnostics10121088. View

11.

Uenishi E, Caldas M, Tsutsui J, Abduch M, Sbano J, Kalil Filho R . Evaluation of cardiac masses by real-time perfusion imaging echocardiography. Cardiovasc Ultrasound. 2015; 13:23. PMC: 4424545. DOI: 10.1186/s12947-015-0018-3. View

12.

Cheson B . PET/CT in Lymphoma: Current Overview and Future Directions. Semin Nucl Med. 2017; 48(1):76-81. DOI: 10.1053/j.semnuclmed.2017.09.007. View

13.

Hasegawa T, Nakagawa S, Chino M, Kunihiro T, Ui S, Kimura M . Primary cardiac sarcoma mimicking benign myxoma: a case report. J Cardiol. 2002; 39(6):321-5. View

14.

Gaballah A, Jensen C, Palmquist S, Pickhardt P, Duran A, Broering G . Angiosarcoma: clinical and imaging features from head to toe. Br J Radiol. 2017; 90(1075):20170039. PMC: 5594986. DOI: 10.1259/bjr.20170039. View

15.

Desai M, Mankad S . Extension of bronchogenic carcinoma through pulmonary vein into the left atrium detected by echocardiography. Echocardiography. 2004; 21(2):189-91. DOI: 10.1111/j.0742-2822.2004.02178.x. View

16.

Miao H, Yang W, Zhou M, Zhu Q, Jiang Z . Atrial Hemangioma: A Case Report and Review of the Literature. Ann Thorac Cardiovasc Surg. 2019; 25(2):71-81. PMC: 6477455. DOI: 10.5761/atcs.ra.18-00207. View

17.

Yuan S . Fetal cardiac tumors: clinical features, management and prognosis. J Perinat Med. 2017; 46(2):115-121. DOI: 10.1515/jpm-2016-0311. View

18.

Yin K, Luo R, Wei Y, Wang F, Zhang Y, Karlson K . Survival outcomes in patients with primary cardiac sarcoma in the United States. J Thorac Cardiovasc Surg. 2020; 162(1):107-115.e2. DOI: 10.1016/j.jtcvs.2019.12.109. View

19.

Brandt R, Arnold R, Bohle R, Dill T, Hamm C . Cardiac angiosarcoma: case report and review of the literature. Z Kardiol. 2005; 94(12):824-8. DOI: 10.1007/s00392-005-0296-0. View

20.

Sun N, Zhang J, Li B, Li A, Lv M, Zhang C . Favorable response to multimodal treatment in hepatocellular carcinoma with inferior vena cava and right atrial tumor thrombus and left adrenal gland metastasis: A case report and literature review. Medicine (Baltimore). 2021; 100(49):e27987. PMC: 8663911. DOI: 10.1097/MD.0000000000027987. View