False aneurysm of ascending aorta due to pericardial mesothelioma

Our plain-English summary of False aneurysm of ascending aorta due to pericardial mesothelioma, by V. Uspenskiy, A. Lavreshin, A. Osadchii, et al (Interactive Cardiovascular and Thoracic Surgery, 2012).

The study

• Authors: V. Uspenskiy, A. Lavreshin, A. Osadchii, M. Gordeev
• Journal: Interactive Cardiovascular and Thoracic Surgery
• Published: 2012;15(2):301-3
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Ascending aortic false aneurysm is a rare but serious complication of pericardial mesothelioma. We report a case of ascending aortic pseudoaneurysm due to spindle cell pericardial mesothelioma. In this case, the first symptoms of the disease appeared 18 months before surgery. The final diagnosis was determined only when severe late complications occurred. Palliative tumour excision, aortoplasty and aortic valve prosthesis were performed with subsequent adjuvant chemotherapy. Over 10 months after surgery, the patient is alive and a significant reduction of the tumour mass has been achieved. This case demonstrates that timely lifetime diagnosis of malignant pericardial tumour remains very difficult and effective adjuvant chemotherapy is needed to improve the results of surgery.

In plain English

This was a case report about one patient treated at a heart centre in St. Petersburg, Russia. A 26-year-old man had chest pain, shortness of breath and fever from November 2009. A scan showed fluid around the heart, but no invasive diagnostic test was done. In April 2011 imaging found a false aneurysm (pseudoaneurysm) of the ascending aorta, 110 mm in diameter. At surgery, the surgeons found tumour nodes on the heart. They partially removed the aneurysm, patched the aortic wall and replaced the aortic valve with a mechanical valve. Complete removal of the tumour was not possible. Tissue tests showed spindle cell mesothelioma of the pericardium (the sac around the heart), with malignant cells at the edges of the aortic defect. After chemotherapy, a scan showed more than 50% reduction of the tumour burden, and he was alive 10 months after surgery. The article did not mention asbestos or any other exposure. The authors concluded that palliative surgery is possible, but radical surgery is imperative and prognosis remains poor, and that effective chemotherapy is needed to improve results.

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 (single patient)
• Who was studied: One 26-year-old man admitted on 19 April 2011 to the Almazov Federal Heart, Blood and Endocrinology Centre, St. Petersburg, Russian Federation
• Exposure: Not reported: the article does not mention asbestos or any other exposure history
• Main results:
  • Symptoms (chest pain, dyspnoea, fever) first appeared in November 2009. A CT scan then showed pericardial effusion, but no invasive diagnostic procedure was performed.
  • Imaging showed a saccular ascending aortic pseudoaneurysm 110 mm in diameter, with partial thrombosis of the cavity
  • At surgery the pseudoaneurysm was partially excised, the aortic wall defect was closed with a xenopericardial patch, and the aortic valve was replaced with a mechanical prosthetic valve
  • The heart was profoundly involved with tumour nodes and the pseudoaneurysm. Complete removal of the tumour was impossible.
  • Immunohistochemical analysis of the pericardial nodes showed spindle cell mesothelioma with high proliferative potency, and malignant cells were found in the edges of the aortic defect
  • After several courses of combined adjuvant chemotherapy, repeat CT showed more than 50% reduction of the tumour burden and no effusion
  • The patient was alive 10 months after surgery
• The authors' conclusion: The authors concluded that palliative resection of malignant pericardial tumours and repair of complications are both possible, but radical surgery is imperative and prognosis remains poor, and that effective adjuvant chemotherapy is needed to improve the results of surgery

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 Mesothelioma, Spindle Cell, Palliative Care, Chemotherapy, Pericardial.

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• Treatment and Outcomes of Primary Pericardial Mesothelioma: A Contemporary Review of 103 Published Cases — E. McGehee, D.E. Gerber, et al. (2019)
• Pericardial Mesothelioma in a 35-Year-Old Male With Ulcerative Colitis — J. Iliff, N.K. Bart, et al. (2019)
• A case of primary pericardial mesothelioma detected by 18F-FDG PET/CT — F. Aga, Y. Yamamoto, et al. (2012)
• Neoplastic Pericardial Disease — J.J. Maleszewski, N.S. Anavekar (2017)

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