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.