Bridging the gap in cardiac mass diagnosis: Advanced imaging, genetic associations, and biomarkers

Abstract

In this editorial we comment on the article by Huffaker et al published in a recent issue of the World Journal of Clinical Cases. We focus on cardiac tumors linked to genetic syndromes and the differential diagnosis of cardiac masses. As cardiomyocytes lack the ability to actively divide, primary cardiac tumors are extremely rare across all ethnicities and age groups. Once they occur, these tumors are often associated with genetic mutations and, occasionally, genetic syndromes. This underscores the importance of considering genetic mutations and syndromes when encountering these cases. The more common growths in the heart are thrombi and vegetations, which can mimic tumors, further making the differential diagnosis challenging. Among the imaging techniques, contrast-enhanced cardiac magnetic resonance imaging has the highest sensitivity for differential diagnosis. To aid in the differential diagnosis of cardiac masses, especially thrombi, appropriate utilization of biomarkers (i.e. D-dimer level) may provide pivotal clinical implications. Employing a multidisciplinary approach that integrates personal history, epidemiological insights, imaging findings, genetic markers, and biomarkers is therefore critical in the diagnostic process of cardiac masses.

Keywords: Cardiac masses; Genetic syndromes; Thrombi; Imaging; D-dimer

Core Tip: The diagnosis of cardiac masses can be challenging because of their frequent atypical manifestations. Accurate differentiation between a thrombus, vegetation, and tumor requires a comprehensive approach that integrates imaging techniques, biomarkers, genetic testing, and a detailed medical history. The management strategies for these masses can vary significantly depending on the diagnosis, which has a direct impact on therapeutic outcomes.