HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Ganesh Shanmugam Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Shanmugam, G. Search for Related Content PubMed PubMed Citation Articles by Shanmugam, G. Related Collections Cardiac - other

Eur J Cardiothorac Surg 2006;29:925-932
© 2006 Elsevier Science NL

Review

Primary cardiac sarcoma

Department of Cardiac Surgery, Royal Hospital for Sick Children, Dalnair Street, Glasgow G3 8SJ, UK

Received 9 October 2005; received in revised form 15 March 2006; accepted 17 March 2006.

^_* Tel.: +44 141 201 0264; fax: +44 141 201 9204. (Email: sgunpat{at}hotmail.com).

Primary malignant lesions of the heart are rare. Although myxomas have been extensively described, there is a paucity of large studies on non-myxomatous cardiac tumours. On the other hand, there are several case reports on specific histopathological variants, in small numbers. Consequently there exists no consensus on therapeutic modalities for cardiac sarcomas. The prognosis for these lesions remains dismal, despite the enhanced diagnostic ability of newer technology. The reasons for the dismal prognosis are (1) the advanced tumour stage at presentation, (2) non-specific symptomatolgy, (3) insufficient awareness of these lesions, due to their rarity, (4) delayed diagnosis and/or misdiagnosis, which leads to (5) advanced tumour stage at presentation. Thus a vicious cycle is created. This article addresses these issues, deals with the surgically relevant modes of presentation, rather than the histopathology, and reviews the diagnosis and management options for the various sarcomas, categorized by the site and extent of cardiac involvement. Clinicians should be familiar with the presentation of these tumours and have a high index of suspicion, since the potential for long-term survival following resection does exist. Wide surgical resection remains the cornerstone of sarcoma therapy. Complete characterization of tumour extent using echocardiography and CT/MRI is mandatory to achieve this goal. Radical resections such as ‘bench surgery’ and transplantation may reduce local recurrence, but the risk of metastatic disease remains. The clinical experience with such approaches is limited. The role of adjuvant therapy is not yet established. In no other field of cardiac surgery would a multidisciplinary approach be more useful, in achieving cure or long-term palliation.

Key Words: Cardiac sarcomas • Lymphoma • Autotransplantation • Transplantation

This article has been cited by other articles:

				C.-C. Sheu, S.-F. Lin, C.-C. Chiu, C.-S. Lee, C.-Y. Chai, Y.-C. Liu, and M.-S. Huang Left Atrial Sarcoma Mimicking Obstructive Pulmonary Disease J. Clin. Oncol., April 1, 2007; 25(10): 1277 - 1279. [Full Text] [PDF]

				A. Hoffmeier, H. H. Scheld, and S. Klotz Survival after radical resection of cardiac sarcomas Eur. J. Cardiothorac. Surg., December 1, 2006; 30(6): 953 - 953. [Full Text] [PDF]