[Cardiac tamponade caused by diffuse pericardial mesothelioma]

A 75-year-old woman was admitted to our hospital because of dyspnea and fever. A chest roentgenogram obtained on admission showed cardiomegaly. An echocardiogram, a computed tomogram, and a magnetic resonance computed tomogram revealed a pericardial tumor and a large pericardial effusion. A tumor biopsy was done under echocardiographic guidance, and sarcomatous mesothelioma was diagnosed on the basis of histological and immunohistological studies of biopsy specimens. Pericardial fenestration followed by tumor resection gave relief from cardiac tamponade. The postoperative course was good, and the patient was discharged from the hospital on the 19th postoperative day. Four months later the pericardial mesothelioma recurred and the patient died of constrictive pericarditis. Palliative resection was useful in this case because it allowed the patient to resume activities of daily living by relieving the cardiac tamponade.