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Cardiac Tumors: From Autoptic Observations to Surgical Pathology in the Era of Advanced Cardiac Imaging

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Cardiac Tumor Pathology

Part of the book series: Current Clinical Pathology ((CCPATH))

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Abstract

Although the term tumor generally recalls the idea of “cancer,” at cardiac level most of primary tumors are biologically benign and malignancy is mostly hemodynamic, due to obstruction of the blood flow because of intracavitary growth and embolism following neoplastic fragmentation with ischemic damage of several organs. The first book on cardiac tumors was published in 1945 by Ivan Mahaim, Professor at the University of Lausanne and was a collection of postmortem observations and a thorough review of the literature. While treating atrial myxoma (“Le polype du coeur”), the most frequent cardiac tumor (nearly two-thirds of primary heart neoplasms), he said “…surgical resection of atrial polyp encounters apparently insurmountable difficulties. However, we should not give up because of this feeling. In any field of science, with technological progress, the impossible is just a moment during the evolution of our powers. As Mummery said about alpinism, the inaccessible peak becomes an easy route for ladies…”. In fact, some years later the era of “surgical pathology” started with the advent of cardiac imaging and open heart surgery in the 1960s, when cardiac neoplasms were diagnosed during life and not only in the autopsy room and became surgically resectable with excellent long-term survival. The historical watershed in the diagnosis and treatment came in the 1980s, with the advent of non-invasive imaging, i.e., echocardiography, which, together with computed tomography and cardiac magnetic resonance, substantially improved non-invasive diagnosis and subsequent treatment. It is possible to easily visualize cardiac tumors at the first onset of symptoms or even incidentally, during routine diagnostic procedures, and send the patient promptly to the surgeon for resection with a nearly 100 % success in the benign forms. Nowadays, the pathologist is on call to achieve the in vivo diagnosis on endomyocardial or surgical biopsies, by establishing the nature (benign, malignant, or non-neoplastic, usually thrombi or vegetations) and the histotype, and to make the differential diagnosis with secondary tumors. In this chapter we will come across single case observations that witness the advances in the clinical diagnosis and therapy of cardiac tumors.

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Authors and Affiliations

  1. Pathological Anatomy, Department of Cardiac, Thoracic and Vascular Sciences, Azienda Ospedaliera-University of Padua Medical School, via A. Gabelli, 61, Padua, 35121, Italy

    Gaetano Thiene M.D., Marialuisa Valente M.D. & Cristina Basso M.D., Ph.D.

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  1. Gaetano Thiene M.D.
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  2. Marialuisa Valente M.D.
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  3. Cristina Basso M.D., Ph.D.
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Correspondence to Gaetano Thiene M.D. .

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Editors and Affiliations

  1. Thoracic and Vascular Sciences, Department of Cardiac, University of Padua, Padova, 35121, Italy

    Cristina Basso

  2. Thoracic and Vascular Sciences, Department of Cardiac,, University of Padua, Padova, 35121, Italy

    Marialuisa Valente

  3. Thoracic and Vascular Sciences, Department of Cardiac,, University of Padua, Padova, 35121, Italy

    Gaetano Thiene

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Thiene, G., Valente, M., Basso, C. (2013). Cardiac Tumors: From Autoptic Observations to Surgical Pathology in the Era of Advanced Cardiac Imaging. In: Basso, C., Valente, M., Thiene, G. (eds) Cardiac Tumor Pathology. Current Clinical Pathology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-143-1_1

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  • DOI: https://doi.org/10.1007/978-1-62703-143-1_1

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