Historical Background

The first description of a cardiac tumor as an anatomic finding was by Realdo Columbus in Padua, Italy, in 1559.[1] The field was otherwise relatively stagnant until 1931, when Yates established a classification system similar to what is in use today in a report on 9 cases of primary tumors from pathologic examination.[2] The first antemortem diagnosis of a cardiac tumor was made by Barnes in 1934.[3] Using electrocardiography and biopsy of a metastatic lymph node, he was able to establish the diagnosis of a cardiac sarcoma.

The first surgical treatment of a cardiac neoplasm was performed by Beck in 1936, with successful removal of a teratoma on the external surface of the right ventricle.[4] Bahnson is credited with the first removal of a right atrial myxoma performed with inflow occlusion; however, the patient died (postoperative) on day 24.[5] The advent of cardiopulmonary bypass by John Gibbon in 1953 greatly augmented the treatment for cardiac tumors. Resections of left-sided intracardiac tumors were first described by Craaford in Sweden in 1954.[6] By 1964, removal of 60 intracardiac neoplasms had been reported.

The technological advancements in imaging modality have provided early diagnostic techniques, surgical and medical management of cardiac tumors.[7] While there are standardized surgical approaches for the most common benign primary cardiac tumors, there is limited large studies validating surgical management of malignant cardiac tumors due to the rarity and variability of these cases. This chapter will focus on the epidemilogy and classification of primary benign, primary malignant and metastic cardiac neoplasms.