Incidental localized (solitary) mediastinal malignant mesothelioma

Abstract

Primary mediastinal mesotheliomas are rare tumours. The mesothelial lining cells of the the pericardium are suggested as the most probable cells of origin. Most of these tumours appear either as a diffuse or nodular thickening of the pericardium that encase and even invade the heart. Localized mediastinal mesotheliomas are distinctly uncommon. We report the imaging findings of a solitary malignant mediastinal mesothelioma that presented mainly as a cystic anterior mediastinal mass. On chest radiography, the tumour appeared as a right paramediastinal soft tissue mass located adjacent to the right middle and lower lobes. On CT, a large, well-circumscribed, right anterior mediastinal mass with a central zone of fluid attenuation was observed. This mass had a thin, smooth wall of uniform thickness as well as a small component that demonstrated soft tissue attenuation. There was no plane of separation between the tumour and aorta/superior vena cava. At surgery the tumour could be dissected easily free from the pericardium and great vessels and it was removed totally. Histopathological examination of the tumour revealed a malignant epitheloid mesothelioma.

Diaphragmatic Hernias: A Cause of Unilateral Loss of The Cardiophrenic Sinus Angle

“…Cardiac pathologies can be classified as pericardial effusion, cardiac lipoma, cardiac masses and epicardial fat tissue [1]. Mediastinal pathologies can be classified as masses, infections and vascular [11,12]. Parenchymal pathologies can be categorized as infections, abscess, empyema, pleural effusion and peripheral lung tumors [1,13].…”

Localized malignant mesothelioma in the middle mediastinum: Report of a case

“…The differential diagnosis of localized pericardial mesothelioma includes a solitary fi brous tumor and synovial sarcoma of the pericardium; however, the imaging and clinical fi ndings are generally unhelpful in the differential diagnosis and these tumors can only be differentiated by histopathological examinations. 3 Chemotherapy and radiation are reported as not very effective against localized malignant mesothelioma. 12 Recently, Vogelzang et al 13 reported the effi cacy of pemetrexed plus cisplatin against malignant pleural mesothelioma, but its effectiveness in the treatment of localized mesothelioma remains unclear.…”

“…10 Conversely, localized pericardial mesothelioma is considered to be a distinct rare variant of malignant mesothelioma. 3 In a review of the English literature, we found only fi ve case reports of localized pericardial mesothelioma, [3][4][5][6][7] and the clinical characteristics of the six patients, including ours, are summarized in Table 1. Four of the six were women and the mean age was 54 years (range, 27-76 years).…”

“…Localized malignant mesothelioma in the mediastinum is even more unusual, and thought to be derived from the mesothelial cells of the pericardium. 3 To our knowledge, only fi ve cases have been reported in the English literature. [3][4][5][6][7] We report another case of localized malignant mesothelioma in the middle mediastinum, which we treated surgically.…”

Epithelioid malignant mesothelioma presenting with features of esophageal tumor

“…1 They usually arise from the mediastinum, and most have been reported as localized malignant pericardial mesothelioma. 2 Other sites from which these tumors were excised, include the lung and even the liver.…”