Prevalence of variety of cardiac tumors presenting to tertiary care center in Eastern Mediterranean area over 21 years

Cardiac tumors are in their majority (>95%) secondary to metastasis, mostly originating from the lung [1]. Primary cardiac tumors are rare tumors that have been reported to occur in 0.001% to 0.030% of autopsy series (refer to Fig. 1a, b) [2]. A variety of primary cardiac tumors have been reported in the literature the prevalence of which varies according to age at presentation (refer to Fig. 2) [3,4]. At the American University of Beirut 23 patients with primary cardiac tumors were diagnosed between the years 1979 and 2000. The mean age at the time of diagnosis was 48T14 year and 11 patients (47.8%) were males. Primary cardiac tumors usually present with one or more of symptoms and signs of intra-cardiac obstruction, systemic embolism, or constitutional complaints [5–7]. The most common presenting constellation of symptoms (65.2%) among our patients can be attributed to mitral valve obstruction due to prolapsed tumors across the mitral valve orifice into the left ventricle. This can be expected because 69.6% (16/23) of these tumors were left atrial myxomas. Interestingly stroke and syncope as a first presentation occurred in 13% (3/23) and 9% (2/23) of the patients, respectively. The tumors were found in the right ventricle in the two patients who had rhabdomyosarcoma, whereas, it was present in the left ventricle in the patient who had fibroelastoma. The two patients (9 year old girl and 5 year old boy), who had rhabdomyosarcoma, died within 3 months during the follow-up period despite radio and chemotherapy, indicating a rapidly fatal disease progression of rhabdomyosarcoma [8]. In our cohort, most of them were followed up for a period of more than 10 years, during