Metastatic tumors are the most common tumors found in the heart. The most common cardiac metastases include lung, breast, melanoma, and lymphoma. Metastases often induce a pericardial effusion.

The most common primary malignancy of the heart is angiosarcoma. Unlike a myxoma, it is usually located in the right atrium. They are characterized by heterogenous signal on T1-weighted images with ares of elevated signal representing hemorrhage. However, angiosarcomas can also be homogenous. Angiosarcomas demonstrate hyperenhancement after the administration of gadolinium contrast agents. Other primary malignant tumors are liposarcoma, leiomyosarcoma, and lymphoma. In general, malignant tumors are more likely to be necrotic, have associated nearby edema, be vascular, demonstrate invasion into adjacent tissues, and have an inhomogeneous appearance.

These SSFP cines shows a large mass in the RV (left) that enhances after administration of gadolinium contrast agent (right). This mass was determined to be metastatic non small cell lung cancer.