Heart Tumors: What Is Malignant And Non-Malignant Heart Cancer? How does it manifest?

Heart Tumors: What Is Malignant And Non-Malignant Heart Cancer? How does it manifest?
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Heart tumors endanger human health and life due to several complications. They can grow directly from the heart or metastasize to it. 

Characteristics

The tumorcancer of the heart is not mentioned as often as other tumors.

Although those growing directly from the heart are not common, they can be serious. Metastases of other cancers to the heart are more common.

The tumor can be malignant or non-malignant. According to which the treatment is further evaluated and the prognosis is assumed. And in malignant forms it is bad. 

Non-malignant tumors are more common and their treatment is more effective. So the prognosis is better.

Tumors are generally known to be the uncontrolled growth of cells, their proliferation. The same is true for heart tumors, which can grow from any part of it.

Don't know the difference? Read the article: Tumor or cancer.

About the heart

The heart is a hollow muscular organ that serves as a pump. It pumps blood and is a carrier of essential substances for the life of cells, tissues or organs, plus it transports waste substances intended for excretion from the body.

Heart - Latin COR. Greek - cardia.

The heart is placed in the chest in the mediastinum (interstitial) behind the sternum (sternum). It is located approximately in the middle, with part of it to the right and a larger section to the left of the center line.

In its vicinity are the lungs on two sides, the thorax, the spine and the diaphragm at the bottom.

Heart weight
300 - 350 grams 
in men, 250 - 300 grams in women. 

It is stored in a bag, which is referred to as the pericardium, professionally the pericardium, which is the fibrous sheath.

The heart is made up of three layers, from the inside:

  • The endocardium is a thin membrane of endothelial cells that also forms the heart valves
  • myocardium, ie the muscle of the heart, which is made up of specialized transverse striated muscle
  • epicardium , i.e. the outer membrane

The heart muscle is the main executive unit of the heart.
The heart is divided into 4 cavities, of which the left ventricle has the thickest and most powerful muscle .

The heart is divided into two halves and 4 cavities. This division has more meanings. And accordingly, the blood circulation is divided into small and large. 

Heart cavities :

  1. right atrium - atrium dextrum
  2. right ventricle - ventriculus dexter
  3. left atrium - atrium sinistrum
  4. left ventricle - ventriculus sinister

When dividing the heart into the right and left halves, we distinguish the heart compartments, ie the septum interatriale - atrial compartment and the septum interventriculare - ventricular compartment.

Between the atria and the ventricles, there are heart valves that serve to direct the flow of blood.

Heart valves prevent blood from moving back during heart activity to the previous heart compartments.

The tricuspid valve, ie the tricuspid valve, is between the right atrium and the ventricle. 
Twin, mitral valve, between left atrium and ventricle.

Tricuspidal valve. 
Double valve valve - valva bicuspidalis or valva mitralis.

The lung (valva trunci pulmonalis) and the aortic valve (valva aortae) are also important. 

Plus...

It is good to mention the heart's transmission system on this topic.

What is it about?

The heart's own transmission system is independent of the rest of the body and the nervous control of the brain. Not completely, in certain directions and certain situations they affect each other.

The sympathetic and parasympathetic have an influence.

The impulse, ie the heart impulse for the heart activity, arises in the sinus node. From this point it spreads further to the atria and, through a perfect system, to the ventricles.

Cardiac excitations or action potentials ensure the work of the heart muscle

After their formation, the heart's transmission system and heart arousals proceed in such a way that the activity of the heart muscle is performed rhythmically, in sequence.

The sequence of contraction and relaxation of the muscle of individual parts of the heart ensures the emptying and filling of individual sections of the heart with blood. 

Arrhythmias - heart rhythm disorders occur in the event of transmission system disorders.

The blood is thus constantly directed to vital organs, all tissues, structures and cells. 

It carries oxygen, among other components, and this is important for the work of all cells of the human body.

And all the time without a break. 

It must be replenished after consumption. What happens in the lungs.

Blood enters the entire human body through two large veins, the upper and lower vena cava into the right atrium. And from here ...

Blood flows:

  1. right atrium
  2. right ventricle
  3. lung
  4. lungs
  5. pulmonary veins
  6. left atrium
  7. left ventricle
  8. aorta
  9. large blood circulation

Blood circulation is divided into small - pulmonary and large body - blood circulation.

Even the heart itself, and therefore the heart muscle in particular, needs oxygen. Blood is supplied to the heart by the coronary arteries, more precisely as coronary arteries (coronary arteries). 

And the blood from the heart is drained through the veins, into the coronary artery, which flows into the right atrium.

Want to know more about heart cancer
What forms do we know?
What are their manifestations
Or treatment options
Read further...

Heart tumors can be ...

Although heart tumors occur less frequently, their presence can seriously endanger human health and life.

The presence of difficulties and their severity depend on several facts.

We distinguish them into several forms and types. 

The basic division is non- toothed, ie benign. However, in the case of the heart, even this species can indicate some more serious complications.

On the contrary, they are malignant, ie malignant tumors also referred to as cancer.

Another type is the division according to where they arise.

Primary heart tumors that grow directly from the heart.

Or...

Secondary. This type of tumor has its original tumor foci elsewhere in the body, with parts of this tumor growth metastasizing to the heart. This can be done either by blood, lymph or by direct contact from the surrounding area.

Depending on the location, they can be found in any layer of the heart, ie from the endocardium, valves, through the myocardium, epicardium to the outer envelope of the heart - the pericardium.

They are usually scattered with several bearings - multifocal or alone - insulated.

Primary versus secondary

Primary tumors arising from the heart are less common and rare.

They are said to affect about 50 people in a million.

Vice versa...

Secondary tumors, i.e. tumor cells metastasized to the heart, are much more common.

Secondary heart tumors are about 40 times more common than primary ones.

It is reported that 10-20% of cases in people with cancer, which spreads throughout the body, also affect the heart. 

In secondary cancer, transmission and spread to the body, and thus to the heart, by the blood or lymphatic route is reported

The second method is contact, ie infiltration, penetration and overgrowth of cancer from the environment.

Some types of cancers that affect the heart:

  • melanoma
  • germinal tumors
  • leukemia
  • lymphoma
  • lungs cancer
  • sarcoma
  • esophageal cancer
  • kidney cancer
  • breast cancer
  • cancer of the oral cavity and tongue, larynx, thyroid gland
  • uterine cancer
  • cancer of the stomach, colon and rectum
  • and other

Metastases (MTS) from another cancer involving the heart directly and primarily are not common. They usually occur when there is a large spread of oncological disease throughout the body.

MTS in the heart can be asymptomatic.
Subsequently, however, they manifest as heart problems.
Therefore, in people with cancer
who also have cardiac problems,
it is necessary to think about secondary oncological heart disease.

The surrounding tumor tissue can grow into the heart. The first is the affected pericardium. In this case, a pericardial effusion forms until the tamponade of the heart can occur

During cardiac tamponade, fluid or even blood accumulates in the heart's envelope. This oppresses the heart, which is not able to expand and draw blood enough into its cavities.

Subsequently, the tumor tissue grows into the heart muscle - myocardium.

Another mechanism is the oppression of the heart from the outside. As the tumor in the chest grows, it overwhelms the heart over time. 

During blood transmission, tumor cells from the liver, adrenal glands or kidneys and testes enter through the inferior vena cava. From the upper vena cava in cancer of the oral cavity or larynx.

Primary - benign and malignant nations

Primary tumors are those that originate directly from cardiac tissue, from either layer.

These are divided into:

  1. benign - benign, non-aggressive, but in the heart area they can cause complications
  2. malignant - malignant, aggressively affecting the surrounding tissue

75 to 80 percent of primary tumors are benign. Of all of them, myxoma is the most common.

Up to 88 - 94% of all malignant tumors is a sarcoma, with a predominance in the form of angiosarcoma.

They are said to be among the most aggressive.

At the time of the first symptoms and diagnosis, metastasis to other parts of the body is confirmed in up to 25-75% of cases.

The table lists benign heart tumors

Title Description
Myxoma
  • mesenchymal tumor
  • benign tumor of mucus connective tissue
  • often as a tumor of the skin and subcutaneous tissue, but also with a possible occurrence in the heart
  • the most common primary benign heart tumor
  • spherical shape, soft jelly-like consistency
  • 80% occurrence in the heart = in the left atrium
    • 15% right atrium
    • 5 for chambers
Fibroma
  • benign tumor of connective tissue
Lipoma
  • benign tumor of adipose tissue
  • sharply demarcated
  • most often subcutaneously
  • but also in the muscles or digestive tract and elsewhere
Teratoma
  • germ cell tumor
  • contains tissue from all three germ layers - tridermoma
Rhabdomyoma
  • muscle-derived tumor
  • rare
  • grows from transverse striated muscle
Cysts
  • pericardial cysts
  • delimited hollow and mostly filled with fluid

The table lists some malignant heart tumors

Title Description
Sarcoma
  • malignant tumor of mesenchymal connective tissue
    • it can be vascular, muscular, bone, cartilage, ligamentous and otherwise
  • in the heart most often angiosarcoma - 28% of sarcomas
    • more common in men and aged 20-50 years
    • mainly the right atrium and pericardium
    • vascular tumor
    • infiltrative growth - overgrowth
    • it also affects the flaps, for example
  • rhabdomyosarcoma - 11% originating from muscle
    • also mostly in men
    • the most common malignant heart tumor in children
    • infiltrative growth, damaging surrounding tissue, often valves
    • bad prognosis
  • other uncommon sarcomas
    • fibrosarcoma 
    • leiomyosarcoma
    • myxosarcoma
    • osteosarcoma
    • mainly left in the hall
Malignant mesothelioma
  • grows out of the pericardium
  • affects the heart muscle
  • suppresses heart cavities
Primary lymphoma of the heart
  • special one
  • mostly in the right heart
    • in the right atrium
  • bad prognosis

Causes

Tumor proliferation = uncontrolled cell growth. 

Tumor cells are abnormal cells, their growth is not controlled, they multiply excessively, without a specific purpose.

And what is the cause? 
Is There A Heart Cancer?

Why tumors and cancer arise is still a matter of research. It is not clear why this is the case, which is the exact cause.

A multifactorial effect is expected. And the blame is on genetic predisposition, but also other and many internal or external factors.

Among the most well-known factors supporting the emergence are assumed to be:

  • genetic and hereditary predisposition
  • obesity
  • smoking
  • other chemical effects of carcinogens
  • drugs
  • alcoholism
  • radiation
  • infection, the best known is probably HPV infection
  • excessive stress
  • poor lifestyle
  • poor diet
  • and other

Symptoms

The symptoms of heart tumors depend on several facts. In this case, it is not so important what the tumor is. 

An important factor is the place where it is located, size and scope. For example, as is the case with the oppression of the surrounding tissue, the restriction of blood flow in the heart cavities, the impact and overgrowth of other layers or heart valves.

The table shows the symptoms of heart tumors

General symptoms of
tumor growth
  • fatigue
  • exhaustion
  • anorexia
  • weight loss
  • night sweats
  • cough, but also coughing up blood
  • muscle weakness, pain
  • increase in body temperature to fever
  • anemia
Obstruction
  • restriction of blood flow
  • at the site where the tumor extends into the interior of the cavities
  • or near the valves - heart valve disease
    • the presence of a murmur
  • sudden and frequent collapses - syncope, falling off
  • heart failure
    • difficulty breathing
    • swelling of the body, primarily of the lower limbs, around the ankles
    • weakness
    • pulmonary edema
Arrhythmia
  • heart disorder
  • heart irregularity
  • palpitations - palpitations
  • when overgrown with the wall of the atrium, the ventricle
  • when the site of excitement and other parts of the cardiac transmission system are affected
  • such as tachycardia, extrasystoles, fibrillation, flutter, AV block up to cardiac arrest - asystole
  • more about arrhythmia
Embolism
  • embolism is the introduction of a foreign object through the bloodstream into another part of the body
    • often by a blood clot or even by tumor cells
  • in heart tumors it can embolize tumor cells, but also a blood clot, ie a thrombus, which forms on tumor cells
  • on embolization into the brain symptoms of stroke
    • embolization into the kidneys, blood vessels of the digestive tract or limbs
Dyspnoea
  • difficulty breathing as a manifestation of heart failure
    • aggravated by activity
  • in tumor obstruction, if it prevents blood flow, or sufficient heart activity to fill or contract the heart muscle
  • in embolization into the lungs and lungs in the case of a tumor in the right half of the heart
Pain
  • chest pain  - can indicate several problems
  • an example is the overgrowth of a tumor through the pericardium - pericardium
  • chest pain when inhaled in pericardial effusion
    • there is a risk of tamponade in pericardial effusion 
      • filling the pericardium with fluid and the inability of the heart to operate as a pump for oppression
  • chest pain in heart attack, for 
    • embolization into the coronary arteries
    • oppression and damage to the coronary arteries
Complications
  •  in terms of embolization into other parts of the body are the cause of difficulties
  • symptoms corresponding to non-bleeding of a given part of the body
    • heart muscle infarction
    • when the blood vessels of the eye become clogged - a vision disorder in one eye
    • stroke
    • indigestion and sudden abdominal event, abdominal pain
    • kidney failure
    • erectile dysfunction
    • non-bleeding limbs, their pain, weakness and movement disorders, cold, pale to purple skin

Diagnostics

If symptoms are present, the anamnesis and subjective and objective symptoms are taken. Make up physical examination, blood sampling for laboratory tests. 

Imaging methods are important :

  • X-ray
  • ECHO - TTE, ie transesophageal ECHO
  • CT
  • MRI
  • PET - positron emission tomography
  • ECG

Histology is usually performed posthumously at autopsy. It has a high risk of complications during life.

Of course, differential diagnosis is important to reveal the cause of the problem. According to which, the further procedure and treatment are governed.

Course

The course of cancer, as well as the symptoms, depends on the location, size, and extent of the nation of the heart.

The possibility is an asymptomatic course - asymptomatic. At this stage, this diagnosis is made at random in addition to another examination.

However, difficulties may appear suddenly. In some cases, the first manifestation may be cardiac arrest and sudden death.

Malignant tumors are aggressive and overgrow the surrounding tissue. So over time, their presence will be proven. It is reported that their metastases elsewhere in the body may occur during this period.

Malignant tumors have a poor prognosis.
Heart sarcoma = the most aggressive heart cancer.

The speed of progress then affects the course of difficulties. 

In non-malignant tumors, the prognosis is better. However, depending on the location and size, their presence can be dramatic.

+

In cancer, secondary tumors and spread to the heart should be considered if heart problems are associated. 

However, metastases in the heart may also not manifest at all.

How it is treated: Heart Tumors

How is a heart tumour treated? Surgery

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Interesting resources

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  • Elbardissi, Andrew W.; Dearani, Joseph A.; Daly, Richard C.; Mullany, Charles J.; Orszulak, Thomas A.; Puga, Francisco J.; Schaff, Hartzell V. (January 2009). "Embolic potential of cardiac tumors and outcome after resection: a case-control study". Stroke40 (1): 156–162. doi:10.1161/STROKEAHA.108.525709. ISSN 1524-4628. PMID 18948602. S2CID 1548077.
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  • Tyebally, Sara; Chen, Daniel; Bhattacharyya, Sanjeev; Mughrabi, Abdallah; Hussain, Zeeshan; Manisty, Charlotte; Westwood, Mark; Ghosh, Arjun K.; Guha, Avirup (June 2020). "Cardiac Tumors: JACC CardioOncology State-of-the-Art Review". JACC: CardioOncology2 (2): 293–311. 
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