Table 3.

Histopathology, Role of Biopsy and Role of Surgery in the Management of Malignant Cardiac Tumors

Tumor	Histopathology	Role of Biopsy	Role of Surgery	Ref. #
Angiosarcoma	Highly vascularized, myocardial infiltration, pleomorphism, necrosis, and mitosis	Usually required, if possible	Complete surgical resection, if possible Surgical resection/debulking to improve symptoms	(26,60)
Leiomyosarcoma	Compact bundles of spindled cells with blunt nuclei, regions of necrosis, and mitotic figures with epithelioid regions are often present	Usually required, if possible	Complete surgical resection, if possible Surgical resection/debulking to improve symptoms	(28)
Rhabdomyosarcoma	Embryonal type with rhabdomyoblasts containing abundant glycogen and expressing desmin, myoglobin, and myogenin	Usually required, if possible	Complete surgical resection, if possible Surgical resection/debulking to improve symptoms	(28)
Osteosarcoma	Histologically heterogeneous, most composed of spindle cell lesions or malignant fibrous histiocytoma, with microscopic foci of osteosarcoma and chondrosarcoma in the spindle regions	Usually required, if possible	Complete surgical resection if possible Surgical resection/debulking to improve symptoms	(61,62)
Undifferentiated sarcoma	Consist of undifferentiated plump spindle cells with frequent mitotic activity and (often) nuclear pleomorphism	Usually required, if possible	Complete surgical resection, if possible Surgical resection/debulking to improve symptoms	(60,63)
Primary cardiac lymphoma	Diffuse large B-cell lymphoma is the most common subtype, although Burkitt lymphoma, low-grade B-cell lymphoma, and T-cell lymphoma have also been described	Required	No role for surgery	(61,64)
Mesothelioma	Epithelioid (plump, rounded), sarcomatoid (spindled), or a combination of either	Pericardial biopsy or pericardial fluid analysis	Complete surgical resection, if possible Pericardiectomy to relieve constriction	(65,66)
Metastasis	Largely dependent on primary tumor	Typically required at site of primary tumor	Surgical debulking only in symptomatic cases	(61,67)