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Primary malignant pericardial mesothelioma
1Department of Cardiovascular Diseases, University Medical Centre, Ljubljana, Yugoslavia.
Abstract:
Malignant primary tumors of the pericardium are rare. The authors present two male patients, aged 44 and 67 years, not exposed to asbestos, who died from pericardial mesothelioma. Repeated evacuation of fluid from the pericardium due to cardiac tamponade failed to reveal the cause of pericarditis. In one case, the diagnosis was made on surgical exploration, and in the other, at autopsy. A significant difference between benign and malignant pericardial effusion was observed. In cases of pericardial mesothelioma, symptoms of epicardial involvement cannot be attributed solely to the hindered inflow and cardiac tamponade, but also to congestive heart failure due to myocardial infiltration. In one patient, temporary improvement was achieved, first by pronisone therapy and then by radiotherapy.
Insights
Malignant pericardial mesothelioma is rare. Diagnosis can be challenging, often requiring surgical exploration or autopsy, and symptoms may indicate advanced myocardial infiltration.
Area of Science:
- Oncology
- Cardiology
- Pathology
Background:
- Malignant primary tumors of the pericardium are exceptionally rare.
- This study focuses on two cases of pericardial mesothelioma in male patients without asbestos exposure.
Observation:
- Patients presented with cardiac tamponade due to pericardial effusion, initially misdiagnosed as pericarditis.
- Diagnosis was confirmed via surgical exploration in one case and autopsy in the other.
- A notable distinction was observed between benign and malignant pericardial effusion characteristics.
Findings:
- Pericardial mesothelioma can lead to congestive heart failure through myocardial infiltration, not just cardiac tamponade.
- Symptoms in these cases were severe, ultimately leading to patient demise.
- Temporary symptom relief was achieved with prednisone therapy and radiotherapy in one patient.
Implications:
- Highlights the diagnostic challenges of rare pericardial tumors.
- Emphasizes the importance of considering myocardial infiltration in mesothelioma cases.
- Suggests potential therapeutic avenues, though outcomes were ultimately fatal.