Long-term survival from multidisciplinary treatment of primary malignant pericardial mesothelioma: A case report

Our plain-English summary of Long-term survival from multidisciplinary treatment of primary malignant pericardial mesothelioma: A case report, by V.A. Hai, N.T.M. Chau, H.V. Hoanh, et al (International Journal of Surgery Case Reports, 2024).

The study

• Authors: V.A. Hai, N.T.M. Chau, H.V. Hoanh, H. Van Tri, D.C. Pho, N. Van Nam
• Journal: International Journal of Surgery Case Reports
• Published: 2024;125:110615
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Introduction And Importance: Primary malignant pericardial mesothelioma is an extremely rare disease with a poor prognosis. Currently, there are no specific guidelines for diagnosis and treatment in Vietnam and international countries for this disease, so treatment experiences from previous clinical cases are very important in the management of this disease.

Case Presentation: The research team reports a clinical case diagnosed and treated with a combination of surgery and chemotherapy using the Pemetrexed + Carboplatin regimen at the Oncology Center. The patient has survived for an additional 17 months up to the current time.

Clinical Discussion: This is an exceptionally rare incident. He survived for a duration of 17 months, which is almost three times longer than the average survival time observed in other documented cases. Additional reports on cases with pericardial mesothelioma are necessary to have a comprehensive understanding of its nature, enabling early identification and appropriate treatment.

Conclusion: The patient underwent surgical intervention and received chemotherapy as part of their treatment. The research team emphasizes the importance of a multidisciplinary approach in diagnosing and treating primary malignant pericardial mesothelioma.

Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.

In plain English

This was a case report from Military Hospital 103 in Hanoi, Vietnam, describing one patient with primary malignant pericardial mesothelioma, a cancer of the lining around the heart. The patient was a 50-year-old man who worked as a driver. He had no documented exposure to asbestos and no prior tuberculosis or exposure to ionizing radiation. He was admitted as an emergency on May 18, 2022, with cardiac tamponade, meaning fluid was compressing the heart. Surgeons took a biopsy, partially removed tumor tissue and created a drainage window into the left chest cavity. They found a 15 × 15 cm tumor on the front of the heart. Tests confirmed epithelioid pericardial malignant mesothelioma. He received six cycles of pemetrexed plus carboplatin. After a drop in white blood cells (grade 2 to 3 leukopenia), he received four more cycles of pemetrexed alone. By January 2023 the disease had spread to the pleura. It did not respond to gemcitabine, and he moved to palliative care. At 17 months after diagnosis he was alive with advanced disease. The authors stated this was almost three times the average survival in other documented cases, and they emphasized a multidisciplinary approach.

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 of a single patient
• Who was studied: One 50-year-old man with no known prior health issues, admitted on May 18, 2022, to Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam
• Exposure: No asbestos exposure was identified. The patient was employed as a driver and had no prior tuberculosis and no exposure to ionizing radiation. The authors considered this likely a case with no identifiable risk factors.
• Main results:
  • During surgery, a 15 × 15 cm tumor was found on the front of the heart. It had invaded surrounding tissues and was compressing the superior vena cava. Only partial removal was possible.
  • After surgery, the pathology diagnosis was epithelioid pericardial malignant mesothelioma.
  • After six cycles of pemetrexed (500 mg/m2) plus carboplatin (AUC 6), given every 21 days, the patient's clinical state was stable.
  • Because of grade 2 to 3 leukopenia, the patient was switched to pemetrexed alone for four more cycles.
  • By January 2023, the disease had progressed to pleural metastasis and bilateral pleural effusion, with growth of the pericardial tumors.
  • The disease did not respond to gemcitabine, and the patient was moved to palliative care.
  • At 17 months after diagnosis, the patient was alive with advanced symptoms, and symptom management was ongoing.
  • The authors stated that this 17-month survival was almost three times longer than the average survival observed in other documented cases.
• The authors' conclusion: The authors emphasized the importance of a multidisciplinary approach, combining surgery and chemotherapy, in diagnosing and treating primary malignant pericardial mesothelioma. They also called for additional case reports.

Topics

Medical terms in this study, explained in our Lexicon: Pericardial Mesothelioma, Prognosis, Chemotherapy, Pemetrexed (Alimta), Carboplatin, Multidisciplinary Team.

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)
• Treatment factors associated with long-term survival after cytoreductive surgery and regional chemotherapy for patients with malignant peritoneal mesothelioma — H.R. Alexander, D.L. Bartlett, et al. (2013)
• Pembrolizumab as an effective treatment for diffuse malignant peritoneal mesothelioma with long‑term survival: A case report and literature review — C. Xue, Z. Dong, et al. (2025)
• Primary Malignant Pericardial Mesothelioma: A Clinical Case Series Illustrating the Necessity of a Multidisciplinary Approach — A.N. Rosenbaum, M.C. Bois, et al. (2019)
• The Antemortem Diagnosis of Primary Malignant Pericardial Mesothelioma: A Multidisciplinary Evaluation — K. Shikano, S. Hirano, et al. (2018)
• Factors influencing long-term survival in mesothelioma patients--results of the German mesothelioma register — V. Neumann, A. Rütten, et al. (2004)

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