Malignant primary pericardial mesothelioma presenting as effusive constrictive pericarditis: a case report study

Savarrakhsh, Amir; Vakilpour, Azin; Davani, Sam Zeraatian-Nejad; Daskareh, Mahyar; Morsaghian, Mahdieh; Salari, Arsalan; Mirrazeghi, Seyedeh Fatemeh

doi:10.1186/s13019-021-01684-8

Cited by 10 publications

(12 citation statements)

References 17 publications

(19 reference statements)

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“…This case report describes a case of primary malignant pericardial mesothelioma with a survival of 2.5 years. This case has some points for discussion, as follows: (I) The most commonly misdiagnosed disease in PMPM is tuberculous pericarditis, where both pericardial lesions are similar, presenting as constrictive pericarditis, with pericardial tamponade and heart failure ( 6 ). When patients with pericardial effusion present with poor antitubercular concurrent with rapid effusion growth, the possibility of malignant mesothelioma of the pericardium needs to be considered, despite its low incidence and clinical rarity.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

“…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 ). Confirmation of the diagnosis relies on histopathological examination ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

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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“…Primary cardiac malignancies are exceedingly rare, with a prevalence of 0.001% to 0.056% and account for 0.3% to 0.7% of all cardiac cancers. 36 Approximately 25% of primary cardiac tumors are malignant, with metastasis being 20 to 40 times more common than in primary malignant tumors. 3,37 Among primary malignant cardiac tumors, malignant pericardial mesothelioma is the third most common tumor after angiosarcoma and rhabdomyosarcoma, and is the most common primary malignant tumor of the pericardium.…”

Section: Malignant Pericardial Mesothelioma Introductionmentioning

confidence: 99%

“…Primary cardiac malignancies are exceedingly rare, with a prevalence of 0.001% to 0.056% and account for 0.3% to 0.7% of all cardiac cancers 36. Approximately 25% of primary cardiac tumors are malignant, with metastasis being 20 to 40 times more common than in primary malignant tumors 3,37.…”

Section: Introductionmentioning

confidence: 99%

Imaging of Malignant Pleural, Pericardial, and Peritoneal Mesothelioma

Strange¹,

Marom

Ahuja³

et al. 2022

Advances in Anatomic Pathology

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Malignant mesothelioma is a rare tumor arising from the mesothelial cells that line the pleura, pericardium, peritoneum, and tunica vaginalis. Imaging plays a primary role in the diagnosis, staging, and management of malignant mesothelioma. Multimodality imaging, including radiography, computed tomography (CT), magnetic resonance imaging (MRI), and F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT), is used in a variety of scenarios, including diagnosis, guidance for tissue sampling, staging, and reassessment of disease after therapy. CT is the primary imaging modality used in staging. MRI has superior contrast resolution compared with CT and can add value in terms of determining surgical resectability in equivocal cases. MRI can further assess the degree of local invasion, particularly into the mediastinum, chest wall, and diaphragm, for malignant pleural and pericardial mesotheliomas. FDG PET/CT plays a role in the diagnosis and staging of malignant pleural mesothelioma (MPM) and has been shown to be more accurate than CT, MRI, and PET alone in the staging of malignant pleural mesothelioma. PET/CT can also be used to target lesions for biopsy and to assess prognosis, treatment response, and tumor recurrence.

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“…Mesothelioma is an aggressive tumor characterized by local invasion and a poor prognosis ( 1 ). Most patients with mesothelioma have a history of exposure to asbestos, and there has been an upward trend in the incidence of mesothelioma in recent years in some areas ( 2 ).…”

Section: Introductionmentioning

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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Malignant primary pericardial mesothelioma presenting as effusive constrictive pericarditis: a case report study

Cited by 10 publications

References 17 publications

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

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

Imaging of Malignant Pleural, Pericardial, and Peritoneal Mesothelioma

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

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