Patients with cancer frequently develop complications in the cardiovascular system. These complications can occur as a result of locally invasive disease or distant spread. Pericardial effusions with tamponade and superior vena cava syndrome are relatively common manifestations of advanced cancers.
Primary tumors of the heart are uncommon and are usually benign. Briefly, the classes of primary tumors that involve the heart include myxomas (which account for 25% to 50% of all primary cardiac tumors), papillary fibroelastomas (10%), rhabdomyomas (of which approximately 50% occur in association with tuberous sclerosis), and lipomas and hemangiomas (5% to 10%). Malignant tumors are usually sarcomas (angiosarcoma being most common) or lymphomas, although primary lymphomas of the heart occur much less frequently than secondary involvement.
In contrast, direct extension of tumors, hematogenous spread, and retrograde lymphatic extension to the heart are common. Based on autopsy studies, involvement of the heart or pericardium occurs in 10% to 12% of all patients with malignant neoplasms. Tumors most likely to involve the heart are primary lung tumors (36% of all patients with cardiac involvement). The grouping of lymphoma, leukemia, and Kaposi sarcoma accounts for 20%, breast cancer for 7%, and esophageal cancer for 6%. Most of these involve the heart by direct extension or regional lymphatic invasion.
Metastases to the myocardium are much less common and are often caused by hematogenous spread of melanomas or lymphomas. From 46% to 71% of patients with melanoma have metastases to the myocardium or pericardium. Although a relatively rare cancer, mesotheliomas commonly invade the pericardium (74% of patients) or myocardium (25% of patients). Patients with myocardial metastases of any origin often present with sudden onset of arrhythmia or, more rarely, conduction abnormalities
Reference: Braunwald Heart disease, Textbook of Cardiovascular Medicine, Ninth edition.