Cardiac tamponade as the initial manifestation of primary pericardial mesothelioma

Our plain-English summary of Cardiac tamponade as the initial manifestation of primary pericardial mesothelioma, by M. Stein, A. Neuman, J. Dale, et al (Medical and Pediatric Oncology, 1995).

The study

• Authors: M. Stein, A. Neuman, J. Dale, K. Drumea, O. Ben-Itzhak, R. Bar-Shalom, D. Goldscher, N. Haim
• Journal: Medical and Pediatric Oncology
• Published: 1995;24(3):208-12
• Type of article: Case report
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Although cardiac tamponade is a known complication of malignancy, it is rarely the initial manifestation. We report a 46-year-old male who presented with malignant cardiac tamponade 6 months prior to the definitive diagnosis of primary pericardial mesothelioma. A thorough literature search has not revealed a similar care.

In plain English

This article was a case report from Israel describing one 46-year-old man with primary pericardial mesothelioma, a cancer of the lining around the heart. He came to the Emergency Ward at Rambam Medical Center in November 1992 with fluid around the heart that pressed on it (cardiac tamponade). Testing of the drained fluid showed metastatic adenocarcinoma, and no original site of cancer was found. He was treated with drainage, a drug instilled into the sac around the heart, and 4 cycles of chemotherapy. In June 1993 the tamponade returned. At emergency surgery, 1,100 cc of bloody fluid was drained, and tumor masses were found in the heart lining and heart muscle. Only part of the tumor could be removed. Tissue examination showed mesothelioma of spindle cell type. After 4 cycles of second-line chemotherapy he had a good clinical response. The authors said they found no other report of this cancer first appearing this way. The authors concluded that tamponade is a very uncommon first sign of this rare cancer. The article did not mention asbestos or the patient's work history.

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 46-year-old male patient seen at Rambam Medical Center (Haifa, Israel), first presenting in November 1992
• Main results:
  • At first presentation, cytology of the fluid drained from around the heart showed metastatic adenocarcinoma
  • A diagnostic work-up did not find a primary site of cancer at that time
  • After initial treatment the patient was free of symptoms until June 1993, when signs of cardiac tamponade returned
  • At emergency pericardiectomy, 1,100 cc of hemorrhagic fluid were drained and only partial resection of the tumor could be attempted
  • Tissue examination showed mesothelioma of spindle cell type with a predominantly tubulopapillary pattern
  • After 4 cycles of second-line chemotherapy the patient had a good clinical response
  • The authors found no other description of primary pericardial mesothelioma first presenting as a malignant pericardial effusion
• The authors' conclusion: The authors concluded that cardiac tamponade is a very uncommon initial presentation of the rare primary pericardial mesothelioma, but that it should be considered when diagnosing any malignant pericardial effusion

Topics

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

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

Related studies

• Sarcomatoid Type Primary Pericardial Mesothelioma with a Long-term Survival after the Onset of Cardiac Tamponade — C. Saisho, H. Ishii, et al. (2016)
• Successful palliation for an aged patient with primary pericardial mesothelioma — R. Isoda, H. Yamane, et al. (2015)
• Unexpected malignant pericardial mesothelioma presenting as pericardial constriction — M. Oc, B. Oc, et al. (2012)
• An unusual case of cardiac tamponade following electrical cardioversion — G.A. Jessurun, H.J. Crijns, et al. (1996)
• Surgical pathology of primary cardiac and pericardial tumors — C. Basso, M. Valente, et al. (1997)
• Three-year survival after surgery for primary malignant pericardial mesothelioma: report of a case — K. Fujita, M. Hata, et al. (2014)

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