Primary pericardial mesothelioma presenting as constrictive pericarditis

Primary pericardial mesothelioma is a rare tumour, often discovered late in a patient's clinical course or at autopsy. Antemortem diagnosis is usually made at the time of surgery. A patient who presented with what appeared to be viral pericarditis in October 1997 is reported. Recurrent symptoms prompted re-evaluation with echocardiography, chest computed tomography, magnetic resonance imaging, cardiac catheterization and a diagnosis of constrictive pericarditis. Associated hepatic dysfunction was found to be secondary to congestion. After operative pericardiotomy and histological examination, primary pericardial mesothelioma was diagnosed. The lesion was surgically debulked.