Primary cardiac tumours are extremely rare with the most commonest being left atrial myxomas. In general, surgical resection is indicated, whenever the tumour formation is mobile and embolization can be suspected. Within 17280 patients receiving heart surgery at the Innsbruck Medical University, 78 patients (0.45%) underwent tumourectomy of primary cardiac tumours. The majority of patients (63) suffered from a left or right atrial myxoma, 12 showed a papillary fibroelastoma of the valves at echocardiographical or histological examination, 1 suffered from a hemangioma, 1 from a chemodectoma, and another one from a rhabdomyosarcoma. The mean age of cardiac tumour patients was 54.29？ ± ？13.28 years (ranging from 18 to 83 years). 67.95% of the patients were female and 32.05% were male. The majority of tumours were found incidentally; 97.44% of the patients showed no tumour recurrence. 1. Introduction Primary cardiac tumours are extremely rare. They are found in only 0.01% of autopsies [1], metastatic tumours being nearly 100 times more common. Approximately 75% of primary cardiac tumours are benign. Tumours of the heart may be classified broadly into three types: benign tumours and tumour-like lesions, malignant tumours, and pericardial tumours [2] (Tables 1 and 2). Table 1: WHO classification of tumours of the heart [ 2]. Table 2: Entity and localisation of heart tumours resected between January 1970 and December 2011 at the Medical University of Innsbruck. Cardiac tumours can present a significant diagnostic challenge causing symptoms and signs that mimic other cardiac diseases. Main symptoms include breathlessness, fever, weight loss, syncope, haemoptysis, and sudden death. Cardiac tumours may also cause embolization, arrhythmias (atrioventricular block and ventricular tachycardia), or obstruction of the outflow tracts. Diagnosis depends on a high index of suspicion and can almost always be made by echocardiography. Differentiation of cardiac tumours from valvular vegetation and atrial thrombus is important, and usually the echocardiographic appearance of a myxoma or a papillary fibroelastoma is quite distinctive. Benign tumours normally carry a good prognosis with normal life expectancy after resection. Patients who have had benign tumours resected are usually followed up with regular echocardiography and cardiological supervision. Malignant tumours such as sarcomas tend to have a poor outcome despite intervention, with a median survival from initial diagnosis of about 6 months. Occasional cases of survival due to complete resection do occur. Secondary
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