Thoracic Neoplasia

62 Thoracic Neoplasia

Metastatic tumors are the most common neoplasias involving the heart; primary lipomas and myxomas are rarer. The latter is demonstrated in the axial cine image in Fig. 62.1A as a large moderate SI mass attached to the left atrium—the most common site of origin—and extending into the left ventricle. Detection of such an atrial attachment distinguishes a myxoma from intracardiac thrombus. Myxoma SI characteristics vary depending on the amount of blood products and calcification present. Enhancement is also variable. Intracardiac lipomas are distinguished by their high SI (due to the presence of fat) on T1WI. Malignant cardiac tumors (i.e., rhabdomyosarcomas) are rarer still and are suggested by a wide base of attachment or the concomitant presence of a hemorrhagic pericardial effusion.

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