{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T12:17:01Z","timestamp":1789301821419,"version":"build-2803163510"},"reference-count":24,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T00:00:00Z","timestamp":1754265600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Cardiac tumors are rare neoplasms with a wide spectrum of clinical presentations, ranging from asymptomatic cases to fatal outcomes. According to the 2021 thoracic tumor classification of the World Health Organization (WHO), papillary fibroelastoma (PFE) is the most common primary cardiac tumor. This study aimed to aggregate and examine data regarding the prevalence, clinical characteristics, and histological results of cardiac tumors. Methods: This multicenter retrospective study was conducted across seven tertiary care institutions and included 274 patients diagnosed with histopathologically confirmed cardiac tumors between January 2013 and December 2024. Results: This study included 274 patients, with an average age of 52.6 \u00b1 16.6 years. Of the study participants, 120 (43.8%) were male and 154 (56.2%) were female. The most prevalent clinical manifestations were dyspnea (43.7%), thoracic pain (22.5%), and cardiac palpitations (21.1%). Echocardiography was the principal diagnostic method, revealing an average tumor size of 3 cm. The most commonly observed mass was cardiac myxoma (CM) in 192 patients (70.1%). The second most frequently detected mass was PFE (28 cases, 10.2%). The third most common cardiac mass was a metastatic tumor (6.9%). Surgical resection was performed in all patients, with infection being the most prevalent consequence, followed by effusion. Conclusions: Cardiac tumors, albeit uncommon, provide considerable diagnostic and treatment difficulties. Our research is founded on an extensive case series that has been histopathologically validated and sourced from various national tertiary centers. This comprehensive dataset offers epidemiological and clinical insights regarding heart tumors in Turkey. Another key finding of our study is that, even though the 5th edition of the 2021 WHO Classification of Thoracic Tumors lists PFE as the most common primary cardiac tumor, myxoma is actually the most common primary cardiac tumor in our study and in many other studies. This finding demonstrates a significant discrepancy between the current international classification and real-world data and suggests that tumor distribution may be related to regional and demographic differences.<\/jats:p>","DOI":"10.3390\/diagnostics15151951","type":"journal-article","created":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T10:48:08Z","timestamp":1754304488000},"page":"1951","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Primary Cardiac Tumors: Clinical Presentations and Pathological Features in a Multicenter Cohort"],"prefix":"10.3390","volume":"15","author":[{"given":"Esra","family":"\u00c7obankent Aytekin","sequence":"first","affiliation":[{"name":"Department of Pathology, Konya Numune State Hospital, 42000 Konya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kemal","family":"Behzato\u011flu","sequence":"additional","affiliation":[{"name":"Department of Pathology, School of Medicine, Ac\u0131badem University, 34752 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arzu","family":"Ak\u00e7ay","sequence":"additional","affiliation":[{"name":"Ac\u0131badem Pathology Group, Department of Pathology, Yeni Y\u00fczy\u0131l University, 34010 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ay\u015fe","family":"\u00d6zg\u00fcn \u015eahin","sequence":"additional","affiliation":[{"name":"Council of Forensic Medicine, 34180 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9120-0563","authenticated-orcid":false,"given":"Naile","family":"K\u00f6kbudak","sequence":"additional","affiliation":[{"name":"Department of Pathology, Faculty of Medicine, Necmettin Erbakan University, 42080 Konya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1202-8735","authenticated-orcid":false,"given":"Fahriye","family":"K\u0131l\u0131n\u00e7","sequence":"additional","affiliation":[{"name":"Department of Pathology, Faculty of Medicine, Necmettin Erbakan University, 42080 Konya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7807-0717","authenticated-orcid":false,"given":"Aylin","family":"Ok\u00e7u Heper","sequence":"additional","affiliation":[{"name":"Department of Pathology, Faculty of Medicine, Ankara University, 06230 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olcay","family":"Kurtulan","sequence":"additional","affiliation":[{"name":"Department of Pathology, Faculty of Medicine, Hacettepe University, 06100 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9850-5976","authenticated-orcid":false,"given":"G\u00fclay","family":"\u00d6zbilim","sequence":"additional","affiliation":[{"name":"Department of Pathology, Faculty of Medicine, Akdeniz University, 07070 Antalya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reyhan","family":"E\u011filmez","sequence":"additional","affiliation":[{"name":"Department of Pathology, Faculty of Medicine, Cumhuriyet University, 58140 Sivas, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T\u00fclay","family":"Ko\u00e7","sequence":"additional","affiliation":[{"name":"Department of Pathology, Faculty of Medicine, Cumhuriyet University, 58140 Sivas, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Do\u011fu\u015f","family":"\u00d6zdemir Kara","sequence":"additional","affiliation":[{"name":"Council of Forensic Medicine, 06520 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elif","family":"Ocak","sequence":"additional","affiliation":[{"name":"Department of Pathology, Van Training and Research Hospital, 65000 Van, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2115-4124","authenticated-orcid":false,"given":"Ali","family":"Ak\u00f6z","sequence":"additional","affiliation":[{"name":"Department of Public Health, Konya Provincial Health Directorate, 42000 Konya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6687-1587","authenticated-orcid":false,"given":"\u0130rem Hicran","family":"\u00d6zbudak","sequence":"additional","affiliation":[{"name":"Department of Pathology, Faculty of Medicine, Akdeniz University, 07070 Antalya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/S1470-2045(05)70093-0","article-title":"Cardiac tumours: Diagnosis and management","volume":"6","author":"Butany","year":"2005","journal-title":"Lancet Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Lin, Z., Xiao, H., Liu, J., Chen, L., Zhang, H., Huang, Y., Chen, Y., and Lin, J. (2023). Clinical features and prognosis of cardiac metastatic tumors. BMC Cancer, 23.","DOI":"10.1186\/s12885-023-11733-1"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1016\/j.jtho.2021.10.021","article-title":"The 2021 WHO classification of tumors of the heart","volume":"17","author":"Maleszewski","year":"2022","journal-title":"J. Thorac. Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1016\/j.athoracsur.2018.10.023","article-title":"A 20-year experience with resection of primary cardiac tumors and metastatic tumors of the heart","volume":"107","author":"Lau","year":"2019","journal-title":"Ann. Thorac. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1007\/s11864-019-0662-1","article-title":"Cardiac tumors: Clinical presentation, diagnosis, and management","volume":"20","author":"Poterucha","year":"2019","journal-title":"Curr. Treat. Options Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1007\/s00059-016-4508-3","article-title":"Cardiac masses","volume":"42","author":"Gecmen","year":"2017","journal-title":"Herz"},{"key":"ref_7","first-page":"656","article-title":"Cardiac masses: Pathological and surgical features-a multicenter study","volume":"36","author":"Tuncay","year":"2021","journal-title":"Braz. J. Cardiovasc. Surg."},{"key":"ref_8","first-page":"2111","article-title":"Surgical experience of primary cardiac tumor: Single-institution 23-year report","volume":"23","author":"Li","year":"2017","journal-title":"Med. Sci. Monit. Int. Med. J. Exp. Clin. Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2420","DOI":"10.1016\/j.jacc.2015.03.569","article-title":"Prognostic and bioepidemiologic implications of papillary fibroelastomas","volume":"65","author":"Tamin","year":"2015","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2687","DOI":"10.1161\/01.CIR.103.22.2687","article-title":"Clinical and echocardiographic characteristics of papillary fibroelastomas: A retrospective and prospective study in 162 patients","volume":"103","author":"Sun","year":"2001","journal-title":"Circulation"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2236","DOI":"10.1016\/j.jacc.2019.02.019","article-title":"High Prevalence of Subclinical Infarction in Asymptomatic Patients With Silent Left-Sided Cardiac Masses","volume":"73","author":"Manian","year":"2019","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"S7","DOI":"10.1161\/CIRCULATIONAHA.107.783126","article-title":"Survival after resection of primary cardiac tumors: A 48-year experience","volume":"118","author":"Elbardissi","year":"2008","journal-title":"Circulation"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"195","DOI":"10.11622\/smedj.2020041","article-title":"Clinical presentation of cardiac myxoma in a Singapore national cardiac centre","volume":"62","author":"Lee","year":"2021","journal-title":"Singap. Med. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"84","DOI":"10.5507\/bp.2019.053","article-title":"Cardiac papillary fibroelastomas: A 10-year single-center surgical experience and long-term echocardiographic follow-up study","volume":"164","author":"Kolek","year":"2020","journal-title":"Biomed. Pap. Med. Fac. Palacky Univ. Olomouc"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.ijsu.2020.02.039","article-title":"Cardiac tumors prevalence and mortality: A systematic review and meta-analysis","volume":"76","author":"Rahouma","year":"2020","journal-title":"Int. J. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"44","DOI":"10.2459\/JCM.0000000000000114","article-title":"Treating cardiac myxomas: A 16-year Chinese single-center study","volume":"17","author":"Lin","year":"2016","journal-title":"J. Cardiovasc. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1093\/ajcp\/100.6.671","article-title":"Cardiac myxoma: A clinicopathologic study","volume":"100","author":"Burke","year":"1993","journal-title":"Am. J. Clin. Pathol."},{"key":"ref_18","first-page":"906109","article-title":"Primary cardiac tumours: A single-center 41-year experience","volume":"2012","author":"Steger","year":"2012","journal-title":"Int. Sch. Res. Not."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1743","DOI":"10.7314\/APJCP.2013.14.3.1743","article-title":"Clinical and histopathological analysis of 66 cases with cardiac myxoma","volume":"14","author":"Zheng","year":"2013","journal-title":"Asian Pac. J. Cancer Prev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1016\/j.repc.2018.02.011","article-title":"Cardiac papillary fibroelastoma: Report of a surgical series","volume":"37","author":"Rodrigues","year":"2018","journal-title":"Rev. Port. Cardiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2140","DOI":"10.1111\/jocs.15460","article-title":"Surgical excision of a rare cardiac tumor: Cardiac hibernoma","volume":"36","author":"Lee","year":"2021","journal-title":"J. Card. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"37","DOI":"10.2459\/JCM.0000000000000059","article-title":"Incidence rate of primary cardiac tumors: A 14-year population study","volume":"17","author":"Cresti","year":"2016","journal-title":"J. Cardiovasc. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"4434","DOI":"10.21037\/jtd-23-1054","article-title":"Age and treatment disparities in survival of primary malignant cardiac tumors: An analysis of over 40 years and 500 patients","volume":"15","author":"Wang","year":"2023","journal-title":"J. Thorac. Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/j.jaccao.2020.05.009","article-title":"Cardiac tumors: JACC CardioOncology state-of-the-art review","volume":"2","author":"Tyebally","year":"2020","journal-title":"CardioOncology"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/15\/1951\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:22:33Z","timestamp":1760034153000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/15\/1951"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,4]]},"references-count":24,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["diagnostics15151951"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15151951","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,4]]}}}