Pericardial Mesothelioma

Pericardial mesothelioma is a cancer of the pericardium, the thin sac of tissue around the heart. It is the rarest of the main forms of mesothelioma, accounting for about one percent of cases or fewer. It usually shows up as fluid around the heart, chest pain or shortness of breath, and it is often diagnosed late.

Origin

The pericardium, like the pleura and peritoneum, is lined with mesothelial cells, and mesothelioma can arise in any of these linings. Primary pericardial mesothelioma has been reported in the medical literature since the early twentieth century, mostly as single cases and small series because it is so rare.

Significance in Asbestos Context

Because the tumor surrounds the heart, its symptoms look like heart disease: a pericardial effusion (fluid in the sac), constrictive pericarditis, irregular heartbeat or, in severe cases, cardiac tamponade. Diagnosis often comes from fluid drained by pericardiocentesis, a pericardial biopsy, or surgery, and sometimes only at autopsy. Its link to asbestos is less firmly established than for pleural or peritoneal mesothelioma, partly because there are so few cases to study, but many reported patients had asbestos exposure, and pathologists and trusts treat it as a mesothelioma. A pathology report that confirms mesothelioma with immunohistochemistry, rather than another tumor that has spread to the heart, is the key medical record for any claim.

Example Sentence

After two drainages of fluid around her heart, a pericardial biopsy with immunostains confirmed pericardial mesothelioma.

Related Terms

Mesothelioma, Pericardium, Pericardial Effusion, Pericardiocentesis, Cardiac Tamponade, Pericardiectomy, Pericardial mesothelioma guide

Notes

• Ask that the pathology be reviewed by a pathologist experienced with mesothelioma; metastatic cancers to the pericardium are far more common and can be mistaken for it.
• Keep the tissue blocks and slides. With so rare a cancer, a second review is often needed.
• Record every job, home and family exposure to asbestos, just as for pleural mesothelioma.