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Primary malignant pericardial mesothelioma presenting with cardiac tamponade

Shigefumi Matsuyama1, Tomohiro Imazuru2, Masateru Uchiyama2

  • 1Department of Cardiovascular Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan; Department of Cardiovascular Surgery, Teikyo University Hospital, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8606, Japan.

International Journal of Surgery Case Reports
|July 28, 2020
PubMed
Abstract

Insights

Primary malignant pericardial mesothelioma is a rare and lethal cancer. Early diagnosis is challenging, and even with treatment, outcomes remain poor, highlighting the need for careful consideration of surgical intervention.

Area of Science:

  • Oncology
  • Cardiology
  • Pathology

Background:

  • Primary malignant pericardial mesothelioma is an exceptionally rare and aggressive malignancy.
  • Diagnosis is often delayed due to nonspecific symptoms and challenges in initial testing.
  • The disease carries a poor prognosis, with advanced stage at presentation being common.

Observation:

  • A case of a 44-year-old male with primary malignant pericardial mesothelioma is presented.
  • Massive pericardial effusion and a large tumor necessitated surgical intervention.
  • Despite initial improvement post-surgery, the patient succumbed to the disease within 7 months.

Findings:

  • Pericardiocentesis may not yield a definitive diagnosis, necessitating further investigation.
  • Malignant cells in pericardial fluid are not always present, complicating diagnosis.
  • Surgical intervention can alleviate symptoms but has not proven curative.

Implications:

  • Primary malignant pericardial mesothelioma requires a high index of suspicion, even with negative initial diagnostic tests.
  • Current treatment modalities including surgery, chemotherapy, and radiation show limited efficacy.
  • Careful consideration of surgical indications is crucial, balancing potential benefits against risks.
Keywords:
Cardiac tamponadePrimary malignant pericardial mesotheliomaSurgical intervention

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