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Primary Pericardial Mesothelioma Causing Constrictive Pericarditis

Samuel T Luebbe1, Quentin Youmans2, Tim Provias2

  • 1Department of Medicine, McGaw Medical Center of Northwestern University, Chicago, Illinois, USA.

JACC. Case Reports
|April 18, 2025
PubMed

Insights

Primary pericardial mesothelioma (PPM) is a rare cancer that can cause constrictive pericarditis (CP). Early diagnosis using multimodality imaging is crucial for this condition with a poor prognosis.

Area of Science:

  • Cardiology
  • Oncology
  • Pathology

Background:

  • Constrictive pericarditis (CP) is a serious condition affecting the heart's ability to function.
  • Identifying the underlying cause of CP is essential for effective management.
  • Malignancies of the pericardium are rare but can present as CP.

Purpose of the Study:

  • To report a rare case of primary pericardial mesothelioma (PPM) presenting as constrictive pericarditis (CP).
  • To emphasize the diagnostic challenges and prognostic implications of PPM.
  • To highlight the utility of multimodality imaging in diagnosing CP of unclear etiology.

Main Methods:

  • Case report presentation.
  • Review of clinical presentation, diagnostic workup, and treatment.
  • Emphasis on multimodality imaging findings.

Main Results:

  • A rare case of primary pericardial mesothelioma (PPM) was identified as the cause of constrictive pericarditis (CP).
  • The diagnosis of PPM was challenging, underscoring the need for high clinical suspicion.
  • The patient's condition carried a grave prognosis despite interventions.

Conclusions:

  • Primary pericardial mesothelioma (PPM) is an uncommon but critical differential diagnosis for constrictive pericarditis (CP) of unknown origin.
  • Multimodality imaging plays a vital role in the etiological diagnosis of CP.
  • Prompt recognition and diagnosis of PPM are essential for patient management, despite the poor prognosis.
Keywords:
constrictive pericarditispericardial mesotheliomapericardiectomy

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