Primary Malignant Pericardial Mesothelioma Research Articles

Primary malignant pericardial mesothelioma presenting as constrictive pericarditis with an atypical imaging appearance: a case description.

Primary malignant pericardial mesothelioma presenting as constrictive pericarditis with an atypical imaging appearance: a case description.

An Autopsy Case of Primary Malignant Pericardial Mesothelioma -A Comprehensive Review of 95 Cases Reported in Japan-

An Autopsy Case of Primary Malignant Pericardial Mesothelioma -A Comprehensive Review of 95 Cases Reported in Japan-

Primary malignant pericardial mesothelioma in a patient with a history of thoracic radiotherapy and asbestos exposure: A case report

Primary malignant pericardial mesothelioma in a patient with a history of thoracic radiotherapy and asbestos exposure: A case report

Echocardiographic characteristics of primary malignant pericardial mesothelioma and outcomes analysis: a retrospective study

BackgroundLittle is known about the echocardiographic characteristics of primary malignant pericardial mesothelioma (PPM) due to its rarity. The aim of this study was to explore the sex-specific echocardiographic patterns of PPM and risk factors for in-hospital mortality.MethodsA retrospective information retrieval was conducted for cases of PPM reported from China during 1981 and 2015. The diagnosis was made by histopathological examinations and only cases with echocardiographic descriptions were included. Data on the clinical and echocardiographic findings were collected. Difference in clinical, sex-specific echocardiographic characteristics and findings across different time periods were assessed. Logistic regression analysis was performed to explore echocardiographic risk factors for in-hospital mortality.ResultsA total of 64 patients with PPM were included, with a mean age of 39.2 ± 15.6 years and minor male dominance (40, 62.5%). The most common echocardiographic presentations were pericardial effusion (55, 85.9%), pericardial masses (36.4%) and thickening (17.3%), respectively. The positive rate of pericardiocentesis was only 20.9%. Six patients (15.4%) died among 39 cases reporting in-hospital outcome. Logistics analysis identified no clinical or echocardiographic parameters associated with in-hospital mortality (all P > 0.05).ConclusionsThe echocardiographic signs of PPM are basically nonspecific with massive pericardial effusion as the most common sign, although no echocardiographic gender differences or association with in-hospital mortality could be identified.

18F-fluorodeoxyglucose imaging of primary malignant pericardial mesothelioma with concurrent pericardial and pleural effusions and bone metastasis: A case report.

Primary malignant pericardial mesothelioma (PMPM) is an aggressive tumor that originates from the mesothelial cells of the pericardium. PMPM with extensive atrial infiltration and bone metastasis is extremely rare. The diagnosis and staging of PMPM based on anatomical imaging may be difficult when concurrent pericardial and pleural effusions are present. A 28-year-old man presented with progressive chest pain. Concurrent pericardial and pleural effusions were identified on computed tomography. On echocardiography, mild thickening and adhesions of the pericardium with the right ventricle and atrium were observed. 18F-fluorodeoxyglucose (FDG) metabolism imaging revealed increased accumulation in the pericardium and adjacent right atrium. Ring-shaped radioactivity aggregation and bone destruction in the sacrum were demonstrated on 18F-FDG and 99mTc-methyl diphosphonate imaging. The diagnosis of PMPM was subsequently confirmed by pathology. The patient survived for >1.5 years with comprehensive treatment.

A Case Report of Primary Pericardial Malignant Mesothelioma Treated with Pemetrexed and Cisplatin

Primary pericardial malignant mesothelioma (PPM) is a very rare malignancy, with an incidence of less than 0.002% and represents less than 5% of all mesotheliomas. The cause of pericardial mesothelioma is uncertain that differ from pleural mesothelioma which is associated with asbestos exposure. This malignancy is terribly aggressive and has very poor prognosis with less than six months of overall survival. We present a case of a 71-year-old woman who was diagnosed with cardiac tamponade caused by PPM and received chemotherapy with pemetrexed and cisplatin for six months. During two years she was alive without disease progression. To better understand the clinical, pathologic features and treatment outcome of this entity, we reviewed 23 cases described in the English literature from 2009, together with our case, provided a total of 24 cases. Based on this review, we suggest that PPM must be considered in patients who have unexplained massive pericardial effusion and recommend chemotherapy with pemetrexed and cisplatin for the better outcome of PPM.

Primary malignant pericardial mesothelioma with increased serum mesothelin diagnosed by surgical pericardial resection: A case report.

A 37-year-old female smoker without a history of exposure to asbestos was referred to our hospital with persistent pericardial effusion. Chest computed tomography imaging examination revealed an irregular thickened pericardium with large amounts of pericardial effusion and a small pleural effusion. Fluorodeoxyglucose (FDG) positron emission tomography imaging demonstrated intrapericardial FDG accumulation. Blood tests revealed an increase in serum mesothelin levels. Examination of a surgically resected specimen revealed a grayish-white thickening of the pericardium, with a straw-colored mucinous pericardial effusion. Histopathological examination confirmed the diagnosis of epithelioid malignant mesothelioma. Although the patient's condition temporarily improved, with decreased levels of serum mesothelin during chemotherapy with carboplatin and pemetrexed, she succumbed to cardiac tamponade 18 months after the initial onset of the symptoms. Primary malignant pericardial mesothelioma (PMPM) is an extremely rare and refractory disorder. Thus, an early definitive diagnosis and timely treatment are crucial for the management of PMPM.

374 - Primary Malignant Pericardial Mesothelioma Manifesting as Cardiac Tamponade

374 - Primary Malignant Pericardial Mesothelioma Manifesting as Cardiac Tamponade

Positive response of a primary malignant pericardial mesothelioma to pemetrexed plus cisplatin followed by pemetrexed maintenance chemotherapy: A case report.

Primary malignant pericardial mesothelioma (PMPM) is a rare tumor with poor prognosis. Surgery is the treatment of choice, but numerous cases are inoperable. For the treatment of inoperable or metastatic cases, systemic chemotherapy is required. However, a standard chemotherapeutic regimen for the treatment of pericardial mesothelioma has not yet been established. Chemotherapy involving pemetrexed and cisplatin has been actively used in the treatment of pleural or peritoneal mesothelioma, and may be considered for the treatment of PMPM. The present study reports the case of a patient with PMPM with lung metastasis who demonstrated a positive response to treatment with pemetrexed and cisplatin followed by pemetrexed maintenance chemotherapy, leading to prolonged progression-free survival for 21 months.

Pericardial Effusion due to Primary Malignant Pericardial Mesothelioma: A Common Finding but an Uncommon Cause.

This case report describes a 37-year-old female who was admitted to our Emergency Department because of shortness of breath. On physical examination, she had dyspnea and tachycardia and blood pressure was 80/50 mmHg with a pulsus paradoxus of 22 mmHg. Neck veins were distended, heart sounds were distant, and dullness was found on both lung bases. Her chest X-ray revealed bilateral pleural effusion and cardiomegaly. On both computed tomography and echocardiography the heart was of normal size and a large pericardial effusion was noted. The echocardiogram showed signs of impending tamponade, so the patient underwent an emergent pericardiocentesis. No infectious etiology was found and she was assumed to have viral pericarditis and was treated accordingly. However, when the pericardial effusion recurred and empirical therapy for tuberculosis failed, a pericardial window was performed. A typical staining pattern for mesothelioma was found on her pericardial biopsy specimen. Since no other mesodermal tissue was affected, a diagnosis of primary malignant pericardial mesothelioma was made. Chemotherapy was not effective and she passed away a year after the diagnosis was made. This case highlights the difficulties in diagnosing this uncommon disease in patients that present with the common finding of pericardial effusion.

Symptomatic malignant pericardial effusion due to advanced pericardial malignancies: a palliative approach.

We read with great pleasure the manuscript by Gong et al. published in a recent issue of the Journal of Thoracic Disease . Authors describe a rare pericardial neoplasm—primary malignant pericardial mesothelioma (PMPM)—complicated by superior vena cava compression and pericardial constriction (1). They did a commendable job in describing the diagnostic and treatment challenges related to their case. We would however like to highlight the palliative therapeutic approach which remains an extremely important treatment aspect in such cases.

Unusual Presentation of a Primary Pericardial Malignant Mesothelioma: Constrictive Pericarditis A Case Report and Review of the Literature

Primary malignant pericardial mesothelioma is an extremely rare tumor with high lethality. We report the case of a 30 year-old female without medical history, who was admitted in the department of cardiology for a dyspnea and chest pain due to a large pericardial effusion. A tamponade was confirmed by echocardiography, and emergent pericardial drainage was performed. Twelve months later, the patient developed a hemodynamically relevant pericardial constriction. She underwent a partial pericardectomy. The pericardium was thick and adherent. The histological examination revealed a pericardial infiltration by malignant mesothelioma. After surgery, five cycles of chemotherapy with carboplatine were beginned. The treatment methods of primary pericardial mesothelioma are limited. Chemotherapy in addition to surgery seems to improve symptoms in case of constriction and non-response to pericardectomy.

Case of Primary Pericardial Mesothelioma

Primary malignant pericardial mesothelioma is extremely rare, with a reported prevalence of 0.0022% at autopsy series. It is, however, the most common primary malignancy of the pericardium. To date, only few hundred cases have been reported in the literature. Unlike peritoneal and pleural mesothelioma, there has been no definite correlation between asbestos exposure and pericardial disease. Malignant pericardial mesothelioma carries a poor prognosis with no successful treatment strategies and little benefit from radiation and chemotherapy. We report a 28 year-old man with no medical history who presented with two weeks of worsening dyspnea on exertion to minimal efforts and severe orthopnea. We discuss the diagnostic approach and therapy in our patient and provide a review of the literature pertaining to the epidemiology, clinical features of pericardial mesothelioma and its diagnosis and treatment. Key words: Cardiac neoplasm, Pericardium, Mesothelioma, Constrictive pericarditis.

A rare case of primary malignant pericardial mesothelioma.

Primary malignant pericardial mesothelioma (PMPM) is a rare tumor of the pericardium. The cause of this tumor is unknown and it has a very poor prognosis. Exposure to asbestos is correlated with the onset of pleural and peritoneal mesothelioma; however, the role of asbestos in pericardial mesothelioma is unclear. Here we highlight the radiological features of this rare tumor and its correlative pathological confirmation with the help of new immunohistochemical (IHC) markers.

A Ball in the Heart: An Interesting Discovery in a Very RareCardiac Tumor.

Primary pericardial malignant mesothelioma is an extremely rare tumor even among all mesotheliomas with about 350 cases reported in the literature so far. Typically, it has an insidious presentation, with nonspecific signs and symptoms, and usually results in constrictive pericarditis, cardiac tamponade or congestive heart failure through either a massive effusion or direct tumurous constriction or invasion to the heart. With the exception of several case reports, the outcome is uniformly dismal and patients typically die within six months of diagnosis. We report a 24 year old male with long history of pleuretic chest paint and admissions with a diagnosis of idiopathic pericarditis, eventually presenting with increasing symptoms of heart failure and a large mobile ball like mass in the heart at echocardiographic and computed tomography studies. At operation, an atypical invasive cardiac tumor was discovered. Complete resection of the tumor was impossible and the patient died from progression of the disease 4 months later.

Three-year survival after surgery for primary malignant pericardial mesothelioma: report of a case

A 59-year-old female underwent surgery for a primary malignant pericardial mesothelioma. She presented with progressive dyspnea, and several imaging studies demonstrated a 65 × 22 mm tumor in the aortopulmonary window, accompanied by massive pericardial effusion. The tumor was successfully excised with clean surgical margins under cardiopulmonary bypass, followed by patch reconstruction of the pulmonary artery, and was diagnosed as an epithelioid type of malignant pericardial mesothelioma. The patient tolerated the operation and subsequent adjuvant chemotherapy without any complications. She remained alive and asymptomatic for almost 3 years after surgery, despite the fact that the median survival of this disease is 6-10 months. This patient is the second longest postoperative survivor of this extremely rare, aggressive neoplasm.

Primary Pericardial Mesothelioma: A Rare Entity

Primary pericardial malignant mesothelioma is an extremely rare neoplasm that arises from the pericardial mesothelial cell layers. Clinical symptoms and signs are frequently nonspecific, and the diagnosis is usually made after surgery or at autopsy. There is no standard treatment for pericardial mesothelioma; nonetheless, radical surgery is the mainstay of therapy for localized disease. The neoplasm is highly aggressive and carries a dismal prognosis with an overall survival of less than six months. This paper presents a case study of a 68-year-old patient with a primary pericardial malignant mesothelioma. Radiologic evaluation revealed a small nodule in the posterior pericardium with pericardial and bilateral pleural effusions. The diagnosis was established after surgery by histological and immunohistochemical studies. The patient remained alive and free of disease for about 24 months; however, due to rapid local recurrence, the patient died 27 months after the surgical treatment.

心不全を症状とした心膜悪性中皮腫の1例

難治性の拡張障害による心不全症状を呈した心膜悪性中皮腫の1例を経験した．症例は67歳，男性．下腿浮腫を中心とした右心不全症状で発症し，入院加療を行い心不全は軽減したが，3カ月後に顔面浮腫，胸水が出現し，心不全の悪化として再入院管理となった．急速に進行したびまん性心膜肥厚による収縮性心膜炎により心不全が増悪するため，心膜開窓を目的に手術を行ったが心膜は全周にわたり肥厚著明で心筋組織と強固に癒着していたため，前面を広い範囲で開窓するにとどまった．術中診断はできず病理検査のカルレチニン染色陽性で悪性中皮腫と診断したが，術後心不全が増悪し術後22日に永眠された．心膜悪性中皮腫はきわめて稀であり，また術前診断は困難であり，予後不良である．しかし，心膜悪性中皮腫は発生増加が予想されるため，収縮性心膜炎治療においてつねに念頭に置かなくてはならない疾患である．

Primary Malignant Sarcomatoid Mesothelioma in the Pericardium

Primary malignant pericardial mesothelioma is an exceptionally rare tumor, and making an antemortem diagnosis of this disease is notoriously difficult. We herein report the case of a 61-year-old woman with pericardial mesothelioma who presented with shortness of breath and peripheral edema of the lower limbs. Chest computed tomography (CT) showed an anterior mass and thickened pericardium with multiple pericardial nodules. A biopsy of the mediastinal mass was performed using right thoracotomy, and the histological findings indicated a sarcomatoid tumor. The patient was treated with chemotherapy; however, she but died three months after diagnosis. An autopsy confirmed a final diagnosis of sarcomatoid type primary malignant pericardial mesothelioma following extensive immunohistopathological examinations.

A Case of Primary Pericardial Mesothelioma Detected by 18F-FDG PET/CT

Primary pericardial mesothelioma is an extremely rare malignancy. We report a case of a 58-year-old woman who presented with fever and fatigue. She had no apparent history of occupational or incidental exposure to asbestos. A postcontrast-enhanced chest CT revealed a 77 × 56-mm mass lesion in the pericardium. The FDG PET/CT was carried out, which demonstrated an intense FDG uptake to a main pericardial tumor and disseminated lesions in the pericardium. Histologic examination confirmed the primary malignant pericardial mesothelioma.