[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [General pathology](https://durgical.com/en/general-pathology/) › [Heart](https://durgical.com/en/general-pathology/areas/heart/) › Tumours of the heart

# Tumours of the heart

- Lesion

Tumours that start in the heart are rare. Most are benign myxomas in the left atrium; tumours spreading from elsewhere are more common.

Updated Nov 12, 2026

## Key points

- Myxoma: about 90 % in the atria, mostly left; ball-valve obstruction of the mitral valve, emboli, fever and weight loss (IL-6).
- Carney complex: multiple myxomas with spotty skin pigmentation and endocrine tumours (PRKAR1A).
- Papillary fibroelastoma: ‘sea anemone’ on valve surfaces; emboli to brain and coronary arteries.
- Rhabdomyoma: children, tuberous sclerosis (TSC1, TSC2); ‘spider cells’; often regresses.
- Angiosarcoma of the heart: usually right atrium; poor prognosis.
- Metastases: melanoma has the highest rate of cardiac spread; lung and breast tumours are the most frequent overall; pericardial effusion is common.

## What it is

Metastases to the heart and pericardium are far more common than primary cardiac tumours. Among primary tumours, the commonest in adults is the myxoma, usually a pedunculated mass in the left atrium attached at the fossa ovalis. Papillary fibroelastomas are frond-like lesions on valves that can embolise. Rhabdomyomas are the commonest cardiac tumour of infants and children, often with tuberous sclerosis, and many regress. Fibromas and lipomas are less common; angiosarcoma is the commonest primary malignant cardiac tumour. Metastases come mainly from lung and breast carcinomas, melanoma, lymphomas and leukaemias.

## Structure

- Myxoma: soft, gelatinous, often lobulated or villous mass on a stalk; microscopy shows stellate or globular myxoma cells forming rings around vessels, in an acid mucopolysaccharide matrix.

## Primary cardiac tumours and metastases

| Tumour | Who and where | Pathology | Problem |
| --- | --- | --- | --- |
| [Myxoma](https://durgical.com/en/conditions/cardiac-tumours/) | Adults; left atrium at the fossa ovalis | Stellate cells in abundant myxoid matrix, haemorrhage | Ball-valve obstruction, emboli, constitutional symptoms |
| Papillary fibroelastoma | Older adults; valve surfaces | Avascular fronds with collagen core and endothelial cover | Embolism |
| [Rhabdomyoma](https://durgical.com/en/conditions/tuberous-sclerosis-complex/) | Infants and children; ventricles | Large vacuolated myocytes with ‘spider cells’ (glycogen) | Obstruction, arrhythmia; tuberous sclerosis |
| Fibroma | Children; ventricular septum | Fibroblasts and collagen | Arrhythmia; Gorlin syndrome |
| Lipoma and lipomatous hypertrophy | Adults; atrial septum | Mature fat | Usually none; atrial arrhythmia |
| Angiosarcoma and other sarcomas | Adults; right atrium | Malignant vascular channels | Effusion, obstruction, metastasis |
| Metastases | Lung, breast, melanoma, lymphoma, leukaemia | Usually pericardial, also myocardial | Effusion, tamponade, arrhythmia |

## Clinical notes

- A myxoma can cause positional syncope, a ‘tumour plop’ sound, or a stroke in a young person; surgical removal is curative.

## Memory aid

Adult heart, left atrium, jelly on a stalk: myxoma; child heart, tuberous sclerosis: rhabdomyoma; and more often than both, a visitor from the lung or breast.

## Test yourself

Think of the answer, then tap the question to see it.

## What is the commonest primary cardiac tumour in adults, and where does it usually arise?

The myxoma, usually in the left atrium near the fossa ovalis.

## Which cardiac tumour is associated with tuberous sclerosis?

The rhabdomyoma.

## Are primary cardiac tumours more common than metastases to the heart?

No; metastases (from lung, breast, melanoma, lymphoma and leukaemia) are far more common.

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## Connections

## Related 5

- [Tumours of infancy and childhood](https://durgical.com/en/general-pathology/tumours-of-infancy-and-childhood/)
- [Pathways of spread and the usual metastatic sites](https://durgical.com/en/general-pathology/pathways-of-spread-and-the-usual-metastatic-sites/)
- [Systemic (arterial) thromboembolism](https://durgical.com/en/general-pathology/systemic-thromboembolism/)
- [Pleural tumours: mesothelioma and solitary fibrous tumour](https://durgical.com/en/general-pathology/pleural-tumours-mesothelioma-and-solitary-fibrous-tumour/)
- [Haemangioendothelioma and angiosarcoma](https://durgical.com/en/general-pathology/haemangioendothelioma-and-angiosarcoma/)

## Related conditions 6

- [Cardiac tumours (atrial myxoma)](https://durgical.com/en/conditions/cardiac-tumours/)
- [Tuberous sclerosis complex](https://durgical.com/en/conditions/tuberous-sclerosis-complex/)
- [Malignant pleural mesothelioma](https://durgical.com/en/conditions/malignant-pleural-mesothelioma/)
- [Lung cancer](https://durgical.com/en/conditions/lung-cancer/)
- [Breast cancer](https://durgical.com/en/conditions/breast-cancer/)
- [Melanoma](https://durgical.com/en/conditions/melanoma/)

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Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given.

Sources: [Heart Diseases | Cardiac Diseases | MedlinePlus](https://medlineplus.gov/heartdiseases.html) (MedlinePlus, US National Library of Medicine, 2025); [Tuberous sclerosis complex: MedlinePlus Genetics](https://medlineplus.gov/genetics/condition/tuberous-sclerosis-complex/) (MedlinePlus, US National Library of Medicine, 2025).

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Source: https://durgical.com/en/general-pathology/tumours-of-the-heart/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/general-pathology/tumours-of-the-heart/