Cardiac sarcoma is a rare type of tumor that occurs in the heart. Cardiac sarcoma is a primary malignant (cancerous) tumor. Tumors are considered to be either primary tumors or secondary tumors. A primary tumor is the original site of tumor growth. A secondary tumor originates from another tumor elsewhere in the body. In general, primary tumors of the heart are rare, and most are benign (noncancerous).
The symptoms of heart tumors will vary, depending on the location of the tumor. Tumors of the heart may occur on the outside surface of the heart, within one or more chambers of the heart (intracavitary), or within the muscle tissue of the heart.
Cardiac sarcomas, most frequently, are a type of sarcoma called angiosarcoma. Most angiosarcomas occur in the right atrium resulting in obstruction of the inflow or outflow of blood. This obstruction may cause symptoms such as swelling of the feet, legs, ankles, and/or abdomen, and distension of the neck veins, because the blood coming back to the heart after traveling through the body cannot easily enter or be pumped out of the right atrium.
Cardiac angiosarcomas that occur on the pericardium can cause increased fluid in the pericardial sac, the thin covering that surrounds the heart. If enough fluid accumulates within the pericardial sac, the heart's ability to pump blood is affected. Some signs of this occurrence may include chest pain, shortness of breath, fatigue, and palpitations.
Tiny pieces (emboli) of cardiac sarcomas may break off and travel through the bloodstream to other parts of the body. An embolus may block blood flow to an organ or body part, causing pain and damage to the organ or body part that lies beyond the point at which the blood flow is obstructed. Emboli can affect the brain (causing a stroke), the lungs (causing respiratory distress), and/or other organs and body parts.
Additional symptoms include hemoptysis (coughing up blood), heart rhythm problems, and upper facial congestion. Other signs of cardiac sarcoma not related to the location of the tumor in the heart may include fever, weight loss, night sweats, and malaise (fatigue, tiredness, or "not feeling well").
The symptoms of cardiac sarcoma may resemble other cardiac or medical conditions. Always consult your doctor for a diagnosis.
The methods for diagnosing cardiac sarcoma vary, to some degree, based on the symptoms present. In addition to a complete medical history and physical examination, diagnostic procedures for cardiac sarcoma may include the following:
Specific treatment for cardiac sarcoma will be determined by the doctor based on:
Once a cardiac sarcoma has progressed to the point that symptoms begin to occur, it has often spread to other parts of the body, making treatment difficult and challenging. This spread to other parts of the body is called metastasis. The type of treatment for cardiac sarcoma depends largely on the location and size of the tumor, as well as the extent of metastasis.
The doctor may determine that the tumor can be removed, which is done with an open-heart surgical procedure. This is often difficult, however, because of the location of the tumor.
In some cases, the sarcoma has invaded the heart to such an extent that it is impossible to remove it completely. In this situation, heart transplantation has been attempted. However, a patient must receive immunosuppressive medication (medications that help to prevent the body from rejecting foreign tissue) after transplant, and this medication may stimulate new growth of sarcoma.
An exciting new prospect for treatment of cardiac sarcoma is autotransplantation. Autotransplantation is a surgical procedure in which the patient's own heart is removed so that the tumor can be more completely and easily removed from the heart tissue. The patient is placed on a heart-lung bypass machine during the surgery. After the tumor is removed, the heart is replaced into the patient. Because the patient has not received a heart from another person, there is no need for immunosuppressive medications. New drug treatments are also being studied, and may be available in clinical trials.
In some cases, radiation therapy or chemotherapy may be given to help relieve symptoms or to improve a person's quality of life.
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