Primary Pericardial Mesothelioma Presenting As Constrictive Pericarditis

Watanabe, Atsushi; Sakata, Junichi; Kawamura, Hideki; Matsuyama, Tsutomu

doi:10.1253/jcj.64.385

Cited by 24 publications

(14 citation statements)

References 4 publications

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“…After this no extent review has been made. Our review includes 29 cases in English literature from 1993 through 2008 where the diagnosis of primary pericardial mesothelioma was established [5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29]. It also includes the findings from our patient and the review, presented in table 1 and table 2.…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Primary Pericardial Mesothelioma: Report of a Patient and Literature Review

Nilsson

Rasmuson

2009

Case Rep Oncol

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Primary mesothelioma of the pericardium is a rare tumor and carries a dismal prognosis. This case report presents a 38-year-old man who suffered from recurrent pericardial fluid. Initial symptoms were unspecific, with dry cough and progressing fatigue. Pericardiocentesis was performed, but analyses for malignant cells and tuberculosis were negative. After recurrence a pericardiectomy was planned. At operation, partial resection of tumor tissue surrounding the heart was performed. Histopathologic examination including immunohistochemical staining for calretinin showed a biphasic mesothelioma. During the postoperative period the patient’s condition ameliorated, but symptoms recurred and the patient died 3 months after diagnosis and 15 months after the first symptoms. At autopsy, the pericardium was transformed by the tumor that also expanded into the mediastinum and had set metastases to the liver. A review of 29 cases presented in the recent literature indicates a higher incidence of malignant pericardial mesothelioma among men than women. Median age was 46 (range, 19–76) years. In pleural mesotheliomas, exposure to asbestos is a known risk factor. However, in primary pericardial mesotheliomas the evidence for asbestos as an etiologic factor seems to be less convincing (3 exposed among 14 cases). Symptoms are often unspecific and cytologic examination of pericardial fluid is seldom conclusive (malignant cells demonstrated in 4/17 cases). Partial resection of the tumor can give a period of symptom reduction. Only a few patients have been treated with chemotherapy. Median survival of patients with pericardial mesotheliomas is approximately 6 months.

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Section: Discussion and Literature Reviewmentioning

confidence: 99%

Primary Pericardial Mesothelioma: Report of a Patient and Literature Review

Nilsson

Rasmuson

2009

Case Rep Oncol

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“…Malignant tumor of the heart (malignant lymphoma, angiosarcoma, mesothelioma, breast cancer or lung cancer), irrespective of the primary or metastatic tumor, is commonly invasive to the pericardium or myocardium, which often results in diastolic dysfunction and some of these cases present with CP. 9,10 Radical pericardiectomy is the definitive treatment for constriction and it is emphasized that timely surgery is needed. 11,12 However, the perioperative mortality is relatively high, especially in cases showing severe impairment of visceral pericardium, severe liver dysfunction, intense calcification of the pericardium and complicated myocardial damage.…”

Section: Discussionmentioning

confidence: 99%

Chronic Pericardial Constriction Induced Severe Ischemic Hepatitis Manifesting as Hypoglycemic Attack

Nomura

Keira

Urakabe

et al. 2009

Circ J

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he correlation between cardiac disease and liver dysfunction is well documented, but constrictive pericarditis (CP) rarely presents with ischemic hepatitis. Case ReportA 57-year-old woman with disturbed consciousness was transported to the emergency room. Her blood pressure was 104/88 mmHg, pulse rate was 98/min with regular rhythm, and she was afebrile. Her jugular vein was distended and showed venous collapse in the diastolic phase. Her legs were considerably edematous. A grade 2/6 systolic regurgitant murmur was audible at the right sternal border in the 4 th intercostal space, but excess heart sounds were unclear. On pulmonary auscultation, sounds were hardly heard in the left lung field. Computed tomography (CT) did not show any evidence of organic lesion in the brain. Though she had no predisposition to hypoglycemia, her serum glucose level was 23 ng/ml and a venous infusion of glucose restored normal consciousness. The first blood gas analysis under 5 L/min oxygen inhaled when just arriving at the hospital showed severe respiratory acidosis (Table 1). However, after recovery of consciousness, the hypercapnia was soon reversed. In addition to low levels of serum glucose, laboratory results showed high necro-inflammatory activity of the liver with an alanine transferase (ALT) level of 1,755 U/L, aspartate transferase (AST) level of 3,615 U/L, lactate dehydrogenase (LDH) level of 5,160 U/L, 47% prothrombin time ratio, and total bilirubin (T-Bil) level of 3.9 mg/dl (Table 1). She was seronegative for both hepatitis B virus (HBV) and hepatitis C virus (HCV), and had not taken any hepatotoxic medicines. Ultrasonography showed no findings of the abdominal organs but there was a small amount of ascetic fluid. Her recent laboratory data and physical (Received October 29, 2007; revised manuscript received March 6, 2008; accepted April 3, 2008; released online November 11, 2008) Department of Cardiovascular Medicine, *Department of Gastroenterology, Nantan General Hospital, Nantan and **Department of Cardiovascular Medicine, Kyoto Prefectural University School of Medicine, Kyoto, Japan Mailing address: Tetsuya Nomura, MD, Department of Cardiovascular Medicine, Nantan General Hospital, 25 Yagi-Ueno, Yagi-cho, Nantan 629-0197, Japan. E-mail: t2-ya@za2.so-net.ne.jp All rights are reserved to the Japanese Circulation Society. For permissions, please e-mail: cj@j-circ.or.jp Chronic Pericardial Constriction Induced Severe Ischemic Hepatitis Manifesting as Hypoglycemic AttackTetsuya Nomura, MD; Natsuya Keira, MD; Yota Urakabe, MD; Daisuke Naito, MD; Mayuka Nakayama, MD; Atsumichi Kido, MD; Hidetoshi Kanemasa, MD*; Hiroaki Matsubara, MD**; Tetsuya Tatsumi, MD Ischemic hepatitis, otherwise known as "shock liver", is characterized by a massive, but transient increase in serum transaminase levels, usually associated with cardiac failure. A patient who did not have a predisposition to hypoglycemia was discovered at home with disturbed consciousness caused by hypoglycemia. She had been diagnosed as having constrictive pericar...

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“…Several studies have shown the efficacy of surgery, radiotherapy, and chemotherapy, but the results are modest and provide no significant difference in prognosis, which remains poor (the median survival is about six months from diagnosis) (5,16). The most frequent causes of death are cardiac tamponade, vena cava occlusion, and congestive heart failure (11,12,17).…”

Section: Discussionmentioning

confidence: 99%

“…The factors contributing to the low incidence of its antemortem diagnosis include the paucity and non-specific nature of the clinical signs and symptoms. Diagnosis is most often made by cytological and histopathological examination (8)(9)(10)(11)(12)(13)(14). Even then, the diagnosis may not be readily apparent on morphology alone and one may need to resort to immunohistochemistry and ultrastructural examination.…”

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confidence: 99%

Primary pericardial mesothelioma presenting as constrictive pericarditis

et al. 2005

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Primary pericardial mesothelioma is an extremely rare and lethal cardiac tumor. We report an autopsy case of a primary pericardial mesothelioma in a 52-year-old man. He developed dyspnea, cough, low-grade fever and night sweats approximately 3 months before last admission. Initially, he was evaluated at a hospital in another city, without a firm diagnosis. Due to progressive symptoms and the development of lower-extremity edema, he presented at our hospital in September 2005. The physical examination at admission demonstrated signs of pericardial tamponade. Chest radiography revealed marked enlargement of the cardiac silhouette. Specimens of bloody pericardial fluid were positive for pericardial mesothelioma by cytologic examination. The general condition of the patient worsened very rapidly and he was transferred to the intensive care unit where he later died. Postmortem examination confirmed primary pericardial mesothelioma of the mixed/biphasic type with lymphatic metastasis in the right lung. By using immunohistochemical analysis for specific markers of mesothelioma and for differentiation of the mesothelioma from the lung adenocarcinoma, definitive diagnosis was established: primary pericardial mesothelioma

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Primary Pericardial Mesothelioma Presenting As Constrictive Pericarditis

Cited by 24 publications

References 4 publications

Primary Pericardial Mesothelioma: Report of a Patient and Literature Review

Primary Pericardial Mesothelioma: Report of a Patient and Literature Review

Chronic Pericardial Constriction Induced Severe Ischemic Hepatitis Manifesting as Hypoglycemic Attack

Primary pericardial mesothelioma presenting as constrictive pericarditis

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