Rare Primary Pericardial Mesothelioma on an [18F]FDG PET/CT Scan and Its Postchemotherapy Response Evaluation

Primary pericardial mesothelioma is a highly aggressive and rare neoplasm that arises from the pericardial mesothelial cell and has a poor prognosis. The diagnosis is usually established by histological and immunohistochemical studies. Malignant mesothelioma most frequently occurs from the pleura (90%), less frequently from the peritoneum and pericardium (6%-10%), and very rarely from the tunica vaginalis in the testis. Most of the patients were retrospectively diagnosed after surgery or an autopsy due to the absence of specific clinical manifestations. We present a case study of a 65-year-old female with primary pericardial mesotheliomas who was investigated with 18F-fluorodeoxyglucose positron emission tomography with computed tomography (FDG PET/CT) scan for biopsy and staging, which shows significant resolution of disease on postchemotherapy response evaluation and underwent pericardiectomy with a progression-free survival of over 12 months.