Primary cardiopericardial tumors are rare. Their incidence in major autopsy studies varies from 0.0017% to 0.28%, with an average incidence of 0.02% in an unselected population.

The current interest in cardiac tumors stems from the significant contribution of non-invasive investigational methods.

All patients underwent both transthoracic (TTE) and transesophageal (TEE) echocardiography for the evaluation of cardiac tumors. In some cases, cardiac magnetic resonance imaging (MRI) was performed to complement the diagnosis.

We report the cases of 12 patients, with an average age of 36 years, including 7 females, 3 males, 2 children, and 1newborn. Among our cases, 11 patients had benign cardiac tumors (7 left atrial myxomas, 1 hydatid cyst of the left ventricle, 1 left ventricular rhabdomyoma, 1 papillary fibroelastoma of the tricuspid valve, and 1 intrapericardial teratoma), and one patient had a primary malignant heart tumor, a lymphoma. Functional symptoms noted included exertional dyspnea in 6 patients, palpitations in 2 cases, malaise and syncope in 2 cases, chest pain in 2 cases, and neurological symptoms in 1case. The diagnosis of myxoma was confirmed by TTE and TEE in all 7 patients, supplemented by MRI in 5 cases. The diagnosis of hydatid cyst was made basedon a constellation of findings. TTE also helped to suspect the diagnosis of rhabdomyoma in a child with tuberous sclerosis complex and papillary fibroelastoma presenting as a pedunculated mass on the atrial side of the septal leaflet of the tricuspid valve. TEE showed the tumor invading the right atrium, both right and left sides of the interatrial septum, and the tricuspid valve in the case of right atrial lymphoma. Surgical treatment was performed in 10of our patients, with uneventful postoperative courses in 7cases (6myxomas and the teratoma), recurrence after3years in the case of the hydatid cyst, and immediate postoperative death in the rhabdomyoma case and after two years in the patient with lymphoma. Conservative management was required in the case of secondary cardiac tumor.

TTE and TEE are indispensable non-invasive examinations for the diagnosis of cardiac tumors. These methods allow for the precise characterization of the nature, location, and extent of the intracardiac mass, thus preparing the ground for surgery.