Cardiac Masses and Tumors

  • Azin Alizadehasl
  • Anita Sadeghpour


Primary tumors of the heart are infrequent across all age groups, with a described prevalence of 0.001–0.03% in autopsy series. Secondary involvement of the heart by extracardiac tumors is 20–40 times more common than that by primary cardiac tumors.

When cardiac tumors are considered in the differential diagnosis, the most ideal initial method of evaluation is echocardiography, either transthoracic (TTE) or transesophageal (TEE)—depending on the clinical circumstances. The sensitivity of TTE and TEE for the detection of a cardiac mass is 93% and 97%, respectively. Therefore, TEE is more comprehensive and accurate than TTE in the evaluation of such masses. Moreover, TEE is particularly advantageous in evaluating right atrial tumors. Three-dimensional echocardiography can assess the size of cardiac masses and define the complex anatomy of the heart. If a cardiac lesion is identified, chest computed tomography with contrast enhancement and cardiac magnetic resonance imaging with contrast are superior modalities for the characterization of the lesions and the description of the extent of tumor involvement. They may also help exclude the possibility of the direct cardiac extension of a tumor, created by the adjacent mediastinal structures.

In this chapter, we will explain other masses such as thrombi, vegetations, cysts, normal structures, and artifacts.


Cardiac masses Cardiac tumors Transesophageal echocardiography Transthoracic echocardiography Myxoma Rhabdomyoma 



Atrial septal aneurysm


American society of echocardiography


Aortic valves


Cardiac echinococcosis




Deep venous thrombosis


Inter-atrial septum


Inferior vena cava


Left atrium


Left Atrial appendage


Magnetic resonance


Mitral valve


Myxomatous valves


Patent foramen ovale


Right atrium


Right ventricle


Tuberous sclerosis





Supplementary material

Movie 36.1

(related to Fig. 36.2): Transthoracic echocardiography, apical for chamber view, large LA myxoma (AVI 7298 kb)

Movie 36.2

(related to Fig. 36.3): Tranesophageal echocardiography, mid esophageal 0° view, large LA myxoma (AVI 15553 kb)

Movie 36.3

(related to Fig. 36.5): Tranesophageal echocardiography, mid esophageal 80° view, mitral valve papillary fibroelastoma (AVI 6244 kb)

Movie 36.4

(related to Fig. 36.6): Transthoracic echocardiography, apical 4chamber view, mitral valve papillary fibroelastoma (AVI 8959 kb)

Movie 36.5

(related to Fig. 36.7): Transthoracic echocardiography para-esternal long axis view. RV round and solid mass that diagnosed by pathology as rhabdomyoma (AVI 9206 kb)

Movie 36.6

(related to Fig. 36.8): Transthoracic echocardiography, apical 4chamber view, benign tumor of LV that diagnosed by pathology as lipoma (AVI 5268 kb)

Movie 36.7

(related to Fig. 36.10): Tranesophageal echocardiography, mid esophageal 90° view, RA mass (thrombus) adjacent the port of chemotherapy (AVI 4497 kb)

Movie 36.8

(related to Fig. 36.11): Transthoracic echocardiography off –axis apical 4 chamber view, large extra cardiac mass that was diagnosed by pathology as Hodjkin lymphoma (AVI 9638 kb)

Movie 36.9

(related to Fig. 36.12): Transthoracic echocardiography, apical 4 chamber view, large intra-myocardial lateral of LV cyst diagnosed as Hydatid cyst (AVI 5030 kb)

Movie 36.10

(related to Fig. 36.13): Transthoracic echocardiography, apical 4 chamber view, large intra-myocardial IVS of LV cyst diagnosed as Hydatid cyst (AVI 7717 kb)


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Azin Alizadehasl
    • 1
  • Anita Sadeghpour
    • 2
  1. 1.Professor of CardiologyEchocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical ScienceTehranIran
  2. 2.Associate Professor of Cardiology, Echocardiologist, Echocardiography and Cardiogenetic Research CentersCardio-Oncology Department, Rajaie Cardiovascular Medical and Research CenterTehranIran

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