A Rare Pericardial Malignancy

Our plain-English summary of A Rare Pericardial Malignancy, by U. Fatima, S. Gupta, D.J. Firchau, et al (Circulation. Heart Failure, 2016).

The study

• Authors: U. Fatima, S. Gupta, D.J. Firchau, A.H. Stolpen, R. Sah
• Journal: Circulation. Heart Failure
• Published: 2016;9(7)
• Type of article: Case report
• Read it: PubMed · Publisher

In plain English

This article was a case report from the University of Iowa about one patient. He was a 60-year-old man with no significant past medical history who had one month of increasing shortness of breath on exertion, fatigue and leg swelling. His history included 45 pack-years of smoking, intravenous drug use, and 2 to 3 years of work as a refuse collector and roof mechanic. The article did not say whether he had been exposed to asbestos. The authors wrote that the link between asbestos and primary pericardial mesothelioma is less clear. Scans showed soft tissue 2.3 cm thick completely encasing the heart and nearby great vessels. His left ventricular ejection fraction, a measure of the heart's pumping, was 25%. During keyhole chest surgery to take a biopsy, his circulation suddenly collapsed, and he died despite resuscitation. Tissue from the surgery and the autopsy led to a final diagnosis of malignant biphasic pericardial mesothelioma, a cancer of the lining around the heart. The authors noted that diagnosis of this disease is often delayed because its symptoms overlap with common heart diseases.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (one patient)
• Who was studied: one 60-year-old man without significant past medical history, treated at the University of Iowa, Iowa City; no dates given
• Exposure: No asbestos exposure is reported for this patient. His recorded history was 45 pack-year smoking, intravenous drug abuse, and 2 to 3 years working as a refuse collector and roof mechanic. In background remarks, the authors wrote that the association between asbestos and primary pericardial mesothelioma is less clear.
• Main results:
  • Imaging showed pericardial soft tissue thickening measuring 2.3 cm that completely encased the heart. The ascending aorta, proximal arch and main pulmonary artery were also encased but remained open.
  • The patient's left ventricular ejection fraction was depressed at 25%. The heart was completely encased by nodular material, and there was no pericardial effusion or tamponade.
  • The patient suffered acute hemodynamic collapse during video-assisted thoracoscopic surgery for biopsy and died despite resuscitation.
  • Autopsy showed smooth pleural surfaces and a tumor based on the outer surface of the heart, encasing the heart and great vessels.
  • Tissue from the biopsy and the autopsy led to a final diagnosis of malignant biphasic pericardial mesothelioma, with both epithelial and spindle tumor cells.
• The authors' conclusion: The authors stated that a definitive diagnosis of primary pericardial mesothelioma is often delayed because the disease lacks characteristic findings and its symptoms overlap with other common cardiac diseases.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pericardial.

Related studies

• Primary pericardial mesothelioma: report of two cases and review of the literature — A.L. Sytman, R.N. MacAlpin (1971)
• Surgical pathology of primary cardiac and pericardial tumors — C. Basso, M. Valente, et al. (1997)
• Neoplastic Pericardial Disease — J.J. Maleszewski, N.S. Anavekar (2017)
• An autopsy case of a malignant pericardial mesothelioma in a Japanese young man — M. Watanabe, H. Suzuki, et al. (1999)
• Pericardial Mesothelioma in a 35-Year-Old Male With Ulcerative Colitis — J. Iliff, N.K. Bart, et al. (2019)
• Primary pericardial tumors — C.S. Restrepo, D. Vargas, et al. (2013)

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