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Molecular Characterization of Pericardial Mesothelioma With Constrictive and Recurrent Pericarditis: TAZ
Ryan Tudino1, Shelby Smith1, Liang Cheng2
1Department of Internal Medicine, Rhode Island Hospital, Warren Alpert School of Medicine at Brown University, Providence, Rhode Island, USA.
Background:
Malignant pericardial mesothelioma (MPM) is a rare, aggressive neoplasm with nonspecific clinical presentations. Although BAP1 loss and CDKN2A deletion are common in pleural mesothelioma, they are not universally present in MPM, complicating diagnosis.
Case Summary:
A 73-year-old man presented with recurrent fever and chest pain from pericarditis. Positron emission tomography-computed tomography and transthoracic echocardiography revealed pericardial thickening and aortitis, concerning for inflammatory or infectious etiology. Initial histopathology was inconclusive. Diagnosis of MPM was confirmed via lymph node biopsy and molecular profiling, which revealed TAZ amplification. The patient was treated with IL-1 blockage and chemotherapy, with symptom improvement.
Discussion:
In BAP1/CDKN2A-negative mesothelial proliferations, molecular testing for additional mutations, including TAZ amplification, may guide diagnostic certainty and novel therapeutic treatment.
Take-Home Messages:
MPM can closely mimic chronic inflammatory disease, and accurate diagnosis with comprehensive profiling is essential to guide targeted therapy. TAZ amplification suggests Hippo pathway as a driver of BAP-intact tumors and may serve as a predictive biomarker of mesothelial immunogenicity.
Insights
Malignant pericardial mesothelioma (MPM) is rare and mimics inflammation. Molecular profiling, including TAZ amplification, aids diagnosis and targeted therapy for BAP1/CDKN2A-negative cases.
Area of Science:
- Oncology
- Molecular Pathology
Background:
- Malignant pericardial mesothelioma (MPM) is a rare, aggressive cancer.
- Clinical presentation is often nonspecific, mimicking inflammatory conditions.
- Common genetic markers like BAP1 loss and CDKN2A deletion are not always present in MPM, complicating diagnosis.
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