Cardiac tamponade due to primary malignant pericardial mesothelioma diagnosed with surgical pericardial resection

Kawakami, Naoki; Kawai, Miki; Namkoong, Ho; Arai, Daisuke; Ueda, Soichiro; Hamada, Kenichi; Kawada, Ichiro; Hasegawa, Naoki; Mikami, Shuji; Asamura, Hisao; Fukunaga, Koichi

doi:10.1016/j.jccase.2021.03.002

Cited by 2 publications

(2 citation statements)

References 7 publications

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“…In the present case, the intraoperative exploration revealed a tumor growing from the the pericardium, with no obvious boundary between the tumor and the left atrium and left ventricle. Previously, PeM was reported to be associated with a large amount of pericardial fluid ( 12 ). The small volume of pericardial fluid and the patient’s inability to lie flat prevented obtaining a biopsy, which made the preoperative diagnosis impossible.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and treatment of pericardial mesothelioma by mediastinal mass resection: a case report

Liang¹,

Zhang²,

Ke³

et al. 2022

Ann Transl Med

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Background: Pericardial mesothelioma (PeM) is a rare disease with non-specific symptoms at the onset, because of its rarity, the relevant literature is limited to case reports and small case series, with no cases exceeding 100 in more than 20 years. As the most common initial symptoms are chest tightness and shortness of breath, early diagnosis is difficult, and the beginning of treatment is easily delayed. We present a rare case of difficult-to-diagnose PeM in which the diagnosis was clarified by surgery and the patient achieved a long survival, providing clinicians with our experience in treating this disease at an early stage of diagnosis and early treatment.Case Description: A 65-year-old female patient attended Affiliated Hospital of Zunyi Medical University, complaining about chest tightness and shortness of breath after activity for the last 2 months, accompanied by edema of the lower limbs in last month. A well circumscribed anterior-mediastinal, partially cystic mass was observed on the chest computed tomography. The patient's heart was compressed by the mass, and the patient had cardiac tamponade symptoms. Cardiac ultrasound showed the enlargement of the right heart, a widened pulmonary artery, pulmonary hypertension, and severe tricuspid regurgitation. The nature of the mass could not be determined prior to the surgery. Anterior superior mediastinal tumour resection and partial pericardial resection and closed thoracic drainage in a median open chest were performed, and pathohistological analysis revealed localized pericardial, epithelioid mesothelioma. In a follow-up after 19 months patient was generally well and without specific discomfort.Conclusions: Differential diagnosis of the anterior mediastinal mass is broad. In patients with a mediastinal tumour who have significant symptoms, are difficult to diagnose and can tolerate surgery, the thoracic surgeon can use surgery as early as possible to make a definitive diagnosis, save the patient's life, and/ or improve the patient's quality of life, experienced pathologist is essential to make fast and correct diagnosis.

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Section: Discussionmentioning

confidence: 99%

Diagnosis and treatment of pericardial mesothelioma by mediastinal mass resection: a case report

Liang¹,

Zhang²,

Ke³

et al. 2022

Ann Transl Med

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“…There are many risk factors for this disease, including exposure to asbestos, post-radiation, and possible viral infection (simian virus 40) ( 1 - 3 ). Previous studies have reported positive autopsy rates of 0.006–0.0022% ( 4 , 5 ). Clinical manifestations include constrictive pericarditis, pericardial tamponade, and heart failure ( 6 ).…”

Section: Introductionmentioning

confidence: 95%

Primary malignant pericardial mesothelioma with a survival of 2.5 years: a case report

Yan¹,

Lv²,

Hu³

et al. 2022

Transl Cancer Res TCR

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Background Primary malignant pericardial mesothelioma (PMPM) is a highly malignant tumor originating in the pericardium serosum with clinical manifestations presenting as constrictive pericarditis, with pericardial tamponade and heart failure. Malignant pericardial mesothelioma is rare and has a poor prognosis, with an average survival time of 6–10 months. Case Description Herein, we report the case of a 57-year-old female who developed chest tightness and panic for no obvious reason. She was diagnosed with tuberculous pericarditis via multiple examinations including positron emission tomography/computed tomography (PET/CT), pleural biochemical routine, tuberculin purified protein derivative (PPD) test, T cell spot (T-SPOT) test, and echocardiography, and was experienced intermittent relief after anti-tuberculosis treatment. On 21 July, 2020, pericardiectomy was performed due to poor therapeutic effect, and the postoperative pathological diagnosis was malignant mesothelioma. After discussing treatment plans and considering the prognosis, the patient opted for palliative care. Subsequently, her symptoms gradually worsened, with chest tightness, shortness of breath, palpitations at rest, frequent arrhythmias, heart failure, cardiogenic shock, and multiple plasma chamber effusions. This case showed that the most common misdiagnosis of PMPM is tuberculous pericarditis, which needs to be differentiated from pleural mesothelioma with pericardial metastasis. Conclusions The diagnosis of PMPM is usually made by pathologic surgery or histopathological examination to determine the specific disease location. In addition, pericardiocentesis fluid exfoliation cytology, imaging and echocardiography can assist diagnosis. Due to the lack of effective treatment for PMPM, timely surgery and postoperative adjuvant chemotherapy are needed to improve the quality of life of patients and prolong their survival time.

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Cardiac tamponade due to primary malignant pericardial mesothelioma diagnosed with surgical pericardial resection

Cited by 2 publications

References 7 publications

Diagnosis and treatment of pericardial mesothelioma by mediastinal mass resection: a case report

Diagnosis and treatment of pericardial mesothelioma by mediastinal mass resection: a case report

Primary malignant pericardial mesothelioma with a survival of 2.5 years: a case report

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