Box 1: Heart tumours that present as cardiacmasses: classificationPaediatric heart tumoursc Hamartomas– Rhabdomyoma– Fibroma– Purkinje cell hamartoma/histiocytoidcardiomyopathyc Germ cell tumoursBenign tumours, seen primarily in adultsc Non-neoplastic masses– Mural thrombi– Lipomatous hypertrophy, atrial septum– Papillary fibroelastomac Benign neoplasms– Myxoma– Paraganglioma/pheochromoctyomaMalignant neoplasmsc Sarcomas– Angiosarcoma (mostly right atrium/pericardium)– Sarcomas with myofibroblastic differentiation(mostly left atrium)– Undifferentiated/malignant fibroushistiocytoma– Leiomyosarcoma– Fibrosarcoma– Osteosarcoma– Rhabdomyosarcoma– Synovial sarcomac Lymphomasc Metastatic tumours (usually right sided)– Carcinomas– Renal cell/hepatocellular, mostlyintracavitary– Sarcomas– Melanoma

Table 1 Incidence of primary cardiac tumours* by meanage at presentation{Tumour type % Mean age at presentationRhabdomyoma{ 2 33 weeksFibroma{ 2 13 yearsRhabdomyosarcoma ,1 15 yearsHaemangioma 1 31 yearsParaganglioma ,1 39 yearsSarcoma (angiosarcoma) 4 40 yearsSarcoma (myofibroblastic) 9 41 yearsMyxoma 76 50 yearsPapillary fibroelastoma 5 59 yearsLipomatous hypertrophy/lipoma ,1 64 yearsPrimary lymphoma 1 67 years*Based on 250 tumour resections from 5 recent institutional surgicalseries.1–5{Based on authors’ experience of consultation material.{Incidence of paediatric tumours varies by institutional setting—that is,proportion of paediatric patients.