Baseline characteristics
During the 15-year period, 73 patients were referred for evaluation of suspected CM. All patients underwent TTE and 63 (86%) were diagnosed with CM or NM cardiac tumor. Of the remaining 10 (14%) patients, five were diagnosed with thrombus and were treated accordingly with anticoagulation therapy. In three cases pseudotumor was diagnosed; one had a prominent Eustachian valve, one had a prominent Chiari network, and one had lipomatous hypertrophy of the interatrial septum. In two patients no obvious cardiac mass was found on repeat TTE.
In 56 cases (77%) additional imaging techniques were used to confirm the diagnosis, either due to suboptimal image quality on TTE or atypical tumor presentation. CMR was used most frequently (n=25, 34%), followed by TEE (n=24, 33%) and CT (n=5, 7%). In two patients PET-CT was performed to detect possible distant metastases. No working diagnosis changed after additional imaging techniques.
After complete diagnostic workup, 53 (84%) of the 63 patients diagnosed with either CM or NM were referred for surgery at our institution. One patient underwent surgery at another institution and was not included in further analysis. The remaining 9 patients did not undergo surgery, either due to poor clinical condition (n=4) or patient’s choice (n=1). In four patients the mass was very small and periodic TTE follow-up was indicated.
The mean age of the operated patients was 64±14 years (26–85 years), 35 patients (66%) were female. The most common complaint was dyspnea (18 patients, 34%), followed by embolic events in 8 patients (15%), chest pain in 5 patients (9%), constitutional signs in 3 patients (6%) and palpitations in 2 patients (4%). Seventeen patients (32%) were asymptomatic. The mass was an incidental finding in 23 patients (43%), most commonly on TTE (61%) and chest CT (39%) performed for other indication.