eMedicine Specialties > Oncology > Carcinomas of the Lung and Other Intrathoracic Carcinomas

Cardiac Sarcoma: Treatment & Medication

Author: John H Raaf, MD, PhD, Professor, Department of Surgery, Case Western Reserve University
Coauthor(s): Anastasios K Konstantakos, MD, Clinical Associate Surgeon, Department of Cardiovascular Surgery, Billings Clinic, Billings, Montana; Heather N Raaf, MD, Chief Deputy Coroner, Cuyahoga County Coroner's Office (Retired)
Contributor Information and Disclosures

Updated: Mar 4, 2009

Treatment

Surgical Care

Cardiac sarcoma is rarely cured, but prolonged survival or significant palliation is possible with surgical resection.8 Exploration with biopsy yields tissue for histologic diagnosis and assessment of the gross extent of the tumor.

  • The role of orthotopic heart transplantation for malignant cardiac tumors continues to be debated.9,10,11,12
  • Bench surgery (explantation and autotransplantation of the heart) may aid in achieving more complete tumor resection.13,14,15
  • Complete or partial excision of primary or metastatic cardiac sarcoma can provide hemodynamic improvement and relief from congestive heart failure. Alternatively, a pericardial window or pericardiectomy may ameliorate symptoms.
  • Postsurgical adjuvant radiation and chemotherapy have not proven consistently beneficial. However, adjuvant radiation or chemotherapy can be beneficial in ameliorating symptoms and improving quality of life.

Consultations

Cardiothoracic surgeon and/or oncologist

More on Cardiac Sarcoma

Overview: Cardiac Sarcoma
Differential Diagnoses & Workup: Cardiac Sarcoma
Treatment & Medication: Cardiac Sarcoma
Follow-up: Cardiac Sarcoma
Multimedia: Cardiac Sarcoma
References
[ CLOSE WINDOW ]

References

  1. Shanmugam G. Primary cardiac sarcoma. Eur J Cardiothorac Surg. Jun 2006;29(6):925-32. [Medline].

  2. Neragi-Miandoab S, Kim J, Vlahakes GJ. Malignant tumours of the heart: a review of tumour type, diagnosis and therapy. Clin Oncol (R Coll Radiol). Dec 2007;19(10):748-56. [Medline].

  3. Simpson L, Kumar SK, Okuno SH, Schaff HV, Porrata LF, Buckner JC, et al. Malignant primary cardiac tumors: review of a single institution experience. Cancer. Jun 2008;112(11):2440-6. [Medline].

  4. Zhang PJ, Brooks JS, Goldblum JR, Yoder B, Seethala R, Pawel B, et al. Primary cardiac sarcomas: a clinicopathologic analysis of a series with follow-up information in 17 patients and emphasis on long-term survival. Hum Pathol. Sep 2008;39(9):1385-95. [Medline].

  5. Zu Y, Perle MA, Yan Z. Chromosomal abnormalities and p53 gene mutation in a cardiac angiosarcoma. Appl Immunohistochem Mol Morphol. Mar 2001;9(1):24-8. [Medline].

  6. Yuan SM, Shinfeld A, Lavee J, Kuperstein R, Haizler R, Raanani E. Imaging morphology of cardiac tumours. Cardiol J. 2009;16(1):26-35. [Medline].

  7. Meng Q, Lai H, Lima J. Echocardiographic and pathologic characteristics of primary cardiac tumors: a study of 149 cases. Int J Cardiol. Jul 2002;84(1):69-75. [Medline].

  8. Reardon MJ, Walkes JC, Benjamin R. Therapy insight: malignant primary cardiac tumors. Nat Clin Pract Cardiovasc Med. Oct 2006;3(10):548-53. [Medline].

  9. Gowdamarajan A, Michler RE. Therapy for primary cardiac tumors: is there a role for heart transplantation?. Curr Opin Cardiol. Mar 2000;15(2):121-5. [Medline].

  10. Grandmougin D, Fayad G, Decoene C. Total orthotopic heart transplantation for primary cardiac rhabdomyosarcoma: factors influencing long-term survival. Ann Thorac Surg. May 2001;71(5):1438-41. [Medline].

  11. Jimenez Mazuecos JM, Fuentes Manso R, Segovia Cubero J, Toquero Ramos J, Oteo Domínguez JF, Alonso-Pulpon Rivera L, et al. [Is heart transplantation for primary cardiac sarcoma a useful therapeutic option?]. Rev Esp Cardiol. Apr 2003;56(4):408-11. [Medline].

  12. Uberfuhr P, Meiser B, Fuchs A. Heart transplantation: an approach to treating primary cardiac sarcoma?. J Heart Lung Transplant. Oct 2002;21(10):1135-9. [Medline].

  13. Hoffmeier A, Deiters S, Schmidt C. Radical resection of cardiac sarcoma. Thorac Cardiovasc Surg. Apr 2004;52(2):77-81. [Medline].

  14. Hoffmeier A, Scheld HH, Tjan TD. Ex situ resection of primary cardiac tumors. Thorac Cardiovasc Surg. Apr 2003;51(2):99-101. [Medline].

  15. Blackmon SH, Patel AR, Bruckner BA, Beyer EA, Rice DC, Vaporciyan AA, et al. Cardiac autotransplantation for malignant or complex primary left-heart tumors. Tex Heart Inst J. 2008;35(3):296-300. [Medline].

  16. Burke AP, Cowan D, Virmani R. Primary sarcomas of the heart. Cancer. Jan 15 1992;69(2):387-95. [Medline].

  17. Dein JR, Frist WH, Stinson EB, et al. Primary cardiac neoplasms. Early and late results of surgical treatment in 42 patients. J Thorac Cardiovasc Surg. Apr 1987;93(4):502-11. [Medline].

  18. Fernandes F, Soufen HN, Ianni BM. Primary neoplasms of the heart. Clinical and histological presentation of 50 cases. Arq Bras Cardiol. Mar 2001;76(3):231-7. [Medline].

  19. Kosuga T, Fukunaga S, Kawara T. Surgery for primary cardiac tumors. Clinical experience and surgical results in 60 patients. J Cardiovasc Surg (Torino). Oct 2002;43(5):581-7. [Medline].

  20. Piazza N, Chughtai T, Toledano K. Primary cardiac tumours: eighteen years of surgical experience on 21 patients. Can J Cardiol. Dec 2004;20(14):1443-8. [Medline].

  21. Raaf HN, Raaf JH. Sarcomas related to the heart and vasculature. Semin Surg Oncol. Sep-Oct 1994;10(5):374-82. [Medline].

  22. Raaf HN, Raaf JH. Sarcomas of the heart and great vessels: vascular replacement. In: Raaf JH, ed. Soft Tissue Sarcomas: Diagnosis and Treatment. St. Louis, Mo: Mosby. Year Book Medical Pub; 1993:123-138.

  23. Sarjeant JM, Butany J, Cusimano RJ. Cancer of the heart: epidemiology and management of primary tumors and metastases. Am J Cardiovasc Drugs. 2003;3(6):407-21. [Medline].

  24. Stevens CW, Sears-Rogan P, Bitterman P, Torrisi J. Treatment of malignant fibrous histiocytoma of the heart. Cancer. Feb 15 1992;69(4):956-61. [Medline].

  25. Stoica SC, Mitchell IM, Foreman J. Atrial transplantation for recurrent cardiac sarcoma. J Heart Lung Transplant. Nov 2001;20(11):1220-3. [Medline].

  26. Vandersalm TJ. Unusual primary tumors of the heart. Semin Thorac Cardiovasc Surg. Apr 2000;12(2):89-100. [Medline].

[ CLOSE WINDOW ]

Further Reading

[ CLOSE WINDOW ]

Keywords

angiosarcoma, metastatic cardiac sarcoma, rhabdomyosarcoma, malignant schwannoma, mesothelioma, fibrosarcoma, malignant fibrous histiocytoma, heart tumor, heart sarcoma, heart malignancy, heart cancer, cancer

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

John H Raaf, MD, PhD, Professor, Department of Surgery, Case Western Reserve University
John H Raaf, MD, PhD is a member of the following medical societies: American Association for Cancer Research, American Association of Endocrine Surgeons, American College of Surgeons, American Society of Clinical Oncology, Central Surgical Association, and Society of Surgical Oncology
Disclosure: Nothing to disclose.

Coauthor(s)

Anastasios K Konstantakos, MD, Clinical Associate Surgeon, Department of Cardiovascular Surgery, Billings Clinic, Billings, Montana
Disclosure: Nothing to disclose.

Heather N Raaf, MD, Chief Deputy Coroner, Cuyahoga County Coroner's Office (Retired)
Heather N Raaf, MD is a member of the following medical societies: American Academy of Forensic Sciences and National Association of Medical Examiners
Disclosure: Nothing to disclose.

Medical Editor

Robert C Shepard, MD, FACP, Associate Professor of Medicine in Hematology and Oncology at University of North Carolina at Chapel Hill; Vice President of Scientific Affairs, Therapeutic Expertise, Oncology, at PRA International
Robert C Shepard, MD, FACP is a member of the following medical societies: American Association for Cancer Research, American College of Physician Executives, American College of Physicians, American Federation for Clinical Research, American Federation for Medical Research, American Medical Association, American Medical Informatics Association, American Society of Hematology, Association of Clinical Research Professionals, Eastern Cooperative Oncology Group, European Society for Medical Oncology, Massachusetts Medical Society, and Society for Biological Therapy
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

CME Editor

Rajalaxmi McKenna, MD, FACP, Consulting Staff, Department of Medicine, Southwest Medical Consultants, SC, Good Samaritan Hospital, Advocate Health Systems
Rajalaxmi McKenna, MD, FACP is a member of the following medical societies: American Society of Clinical Oncology, American Society of Hematology, and International Society on Thrombosis and Haemostasis
Disclosure: Nothing to disclose.

Chief Editor

Jules E Harris, MD, Clinical Professor of Medicine, Division of Hematology/Medical Oncology, Department of Internal Medicine, University of Arizona College of Medicine at Tucson; Consulting Staff, Arizona Cancer Center
Jules E Harris, MD is a member of the following medical societies: American Association for Cancer Research, American Association for the Advancement of Science, American Association of Immunologists, American Society of Hematology, and Central Society for Clinical Research
Disclosure: GlobeImmune Salary Consulting; Amplimed Consulting fee Consulting

RELATED EMEDICINE ARTICLES
 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.