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[Primary pericardial malignant mesothelioma with incomplete endocardial cushion defect; report of a case]

Takashi Okamoto1, H Doi, J Yasuike

  • 1Department of Cardiovascular Surgery, Cardio-vascular Center Hokkaido Ohno Hospital, Sapporo, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|December 22, 2004
PubMed

Insights

A rare primary pericardial malignant mesothelioma case in a woman with a heart defect was successfully treated. Surgical removal of the tumor and heart defect repair led to a positive outcome with no recurrence.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Oncology
  • Pathology

Background:

  • Primary pericardial malignant mesothelioma is a rare and aggressive tumor with a poor prognosis.
  • Late presentation and challenges in complete surgical resection contribute to its poor outcomes.
  • Co-occurrence with congenital heart defects like incomplete endocardial cushion defect (ECD) is exceptionally rare.

Observation:

  • A 46-year-old female presented with symptoms necessitating pericardiectomy.
  • During surgery for an incomplete endocardial cushion defect (ECD), two masses were incidentally discovered in the pericardial space.
  • The masses were successfully removed en bloc along with the total repair of the incomplete ECD.

Findings:

  • Pathological examination confirmed the masses to be primary pericardial malignant mesothelioma.
  • The patient underwent successful surgical management involving en bloc resection of the mesothelioma and complete repair of the incomplete ECD.
  • Post-operative follow-up at 4 months showed no evidence of tumor recurrence.

Implications:

  • This case highlights the possibility of successful surgical management for primary pericardial malignant mesothelioma, even in the presence of congenital heart defects.
  • Aggressive surgical resection, when feasible, may offer a favorable outcome despite the tumor's generally poor prognosis.
  • Further research into multimodal treatment strategies for this rare malignancy is warranted.

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