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[Primary malignant pericardial mesothelioma].

T Fazekas1, L Tiszlavicz, I Ungi

  • 1Szent-Györgyi Albert Orvostudományi Egyetem, Szeged, Belgyógyászati Klinika.

Orvosi Hetilap
|December 1, 1991
PubMed
Summary

A rare malignant pericardial mesothelioma caused a stroke-like event and heart block in a 41-year-old man. The tumor embolism occluded the carotid artery, leading to brainstem herniation and death.

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Area of Science:

  • Cardiology
  • Neurology
  • Oncology

Background:

  • Sudden neurological deficits can arise from various causes, including cardiovascular events.
  • Cardiac tumors are uncommon but can present with diverse and severe clinical manifestations.

Observation:

  • A 41-year-old male presented with acute left hemiparesis, loss of consciousness, and coma.
  • Electrocardiogram (ECG) revealed second-degree atrioventricular (AV) block and complete AV block.
  • Cranial CT and Doppler ultrasound indicated right internal carotid artery occlusion and right cerebral hemisphere infarction.

Findings:

  • Postmortem examination identified a primary malignant pericardial mesothelioma infiltrating the heart, including the AV junction.
  • The tumor caused a tumor embolism that occluded the right internal carotid artery.
  • Histochemical and immunohistochemical analyses confirmed the diagnosis of malignant pericardial mesothelioma.

Implications:

  • This case highlights a rare presentation of cardiac tumors mimicking cerebrovascular accidents.
  • Involvement of the AV node by a pericardial mesothelioma can lead to conduction abnormalities and stroke-like symptoms.
  • Early recognition of such rare etiologies is crucial for patient management, although this case resulted in a fatal outcome.

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