Primary pericardial mesothelioma presenting as multiple pericardial masses on CT

Area of Science:

• Oncology
• Radiology
• Pathology

Background:

• Primary pericardial mesothelioma is a rare malignancy arising from the pericardium.
• It represents the most common primary tumor of the pericardial sac.
• Diagnosis is often challenging due to non-specific clinical and imaging findings.

Observation:

• A 67-year-old male presented with weight loss and was incidentally found to have multiple enhancing pericardial masses on CT scan.
• These imaging findings led to the diagnosis of primary pericardial mesothelioma.
• The masses were identified during imaging for unrelated symptoms.

Findings:

• Pericardial mesothelioma should be included in the differential diagnosis for patients with pericardial effusion, thickening, or masses.
• Radiologists must recognize this rare condition, even when incidentally discovered.
• The clinical presentation of pericardial mesothelioma is often non-specific.

Implications:

• Increased radiologist awareness can lead to earlier diagnosis of this rare condition.
• Timely diagnosis is critical for patient management, despite the universally poor prognosis.
• Further research into diagnostic markers and treatment strategies for pericardial mesothelioma is warranted.