Which of the following statements about malignant cardiac tumors are true?

A. Sarcomas are the most frequent primary malignancy.

B. Metastatic tumors are usually asymptomatic.

DISCUSSION: Twenty per cent of primary cardiac tumors are some variant of sarcoma. Precise histologic classification is not imperative, as all have a similar clinical picture with rapid systemic dissemination and aggressive local invasion. In contrast, metastatic tumors cause symptoms in only 10% of patients. Unfortunately, most primary and secondary cardiac malignancies infrequently respond to systemic chemotherapy or mediastinal irradiation. Surgical treatment is most successful with renal tumors extending into the right atrium. Significant 5-year survival can be achieved with concomitant nephrectomy and intraatrial resection of the tumor thrombus. Relief of tamponade is worthwhile; however, extensive decortication provides little help.