Rapid Review·Cardiovascular
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PATHOLOGY
T2High yieldCardiac Tumors
FA P320
Focus on
The commonest cardiac tumour is not a cardiac tumour, and the two primaries split by age.
Key takeaways
The commonest cardiac tumour is not a cardiac tumour
Metastases first
the most common cardiac tumour is a METASTASIS, for example from melanoma. Primary tumours are far rarer.The two primaries, split by age
Myxoma
the most common primary cardiac tumour in adults. 90% in the atria, mostly the LEFT atrium.- Causes a "ball valve" obstruction, hence multiple syncopal episodes, and can embolize systemically (stroke, acute limb ischemia).
- Secretes IL-6, producing constitutional symptoms of fever and weight loss. "Adults make 6 myxed drinks" for IL-6.
- Early diastolic "tumour plop", which mimics mitral stenosis.
- Histology: gelatinous material, with scattered stellate or globular myxoma cells immersed in abundant glycosaminoglycan ground substance.
Rhabdomyoma
the most common primary cardiac tumour in children, associated with tuberous sclerosis, more common in the ventricles. Histology shows hamartomatous growths.| Feature | Myxoma | Rhabdomyoma |
|---|---|---|
| Population | Adults | Children |
| Location | 90% atria, mostly LEFT atrium | Ventricles |
| Association | IL-6, giving fever and weight loss | Tuberous sclerosis |
| Auscultation | Early diastolic "tumour plop"; ball-valve obstruction causing syncope | Usually silent |
| Histology | Gelatinous, myxoma cells in glycosaminoglycans | Hamartomatous growths |
A left atrial mass with a tumour plop, plus fever and weight loss. Why do the constitutional symptoms disappear after resection?
They come from the IL-6 the myxoma itself secretes; remove the tumour and the cytokine source goes with it.
How it's tested
The most common tumour of the heart is a metastasis, not a primary tumour, and that is the first thing asked from this page. A left atrial mass with a tumour plop plus fever and weight loss is a myxoma, and the constitutional symptoms come from IL-6 secreted by the tumour itself, which is why they resolve on resection. In a child, the same intracardiac mass with tuberous sclerosis is a rhabdomyoma instead.
Go deeper
First Aid 2026 — CV/Pathology (p.320) · B&B — Cardiac tumours · Mehlman — HY Cardio (ball-in-valve murmur, myxoma IL-6)
Flashcards for this page
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"(...)" obstruction of the (...) valve
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