Primary
cardiac tumors are rare clinical entities. Benign
tumors are often amenable to surgical excision, whereas malignant
tumors are seldom resectable. The literature has reported that 28 patients have undergone orthotopic
heart transplantation for inoperable primary
cardiac tumors. The results of these transplants are presented in this article. Of the 28 patients who underwent orthotopic
heart transplantation for primary
cardiac neoplasms, 7 patients had benign histology (fibroma-5, rhabdomyoma-1, and pheochromocytoma-1) and 21 patients had malignant histology (
sarcoma-15, malignant fibrohistiocytoma-3, and
lymphoma-3). Mean survival in the patients with benign histology was 46 months, and the mean survival in the patients with malignant histology was 12 months. However, there were seven patients with malignant histology who had survived for a mean of 27 months without evidence of recurrent disease. An awareness by clinicians of the presenting clinical picture of these
tumors is warranted in view of the potential for cure by resection or
transplantation. Patients with benign primary
cardiac tumors appear to benefit from the complete resection afforded by cardiectomy and
transplantation. The role of
transplantation for patients with malignant
tumors remains unclear. Further experience and continued follow-up of these patients is necessary to ascertain the role of
cardiac transplantation, radiation, and
chemotherapy in the management of patients with primary
tumors of the heart.