Letter regarding Flecher et al. “Cancer on a pacemaker lead” — Is it MICE (Mesothelial Incidental Cardiac Excrescence)?

Abstract

This article interested me. The authors describe a 3.5×3×4cm mass on a pacemaker lead [1]. The photomicroscopy images are very good and from them I wondered if this could be an example of a MICE (Mesothelial Incidental Cardiac Excrescence) [2]. These enigmatic lesions have been described and may display pleomorphism with mitotic activity. The cells in the photographs resemble mesothelial cells to me and these can be cytokeratin positive. This could explain the occurrence of this lesion in the absence of an underlying cancer.