Malignant mesothelioma of the pericardium: a report of two different presentations

Our plain-English summary of Malignant mesothelioma of the pericardium: a report of two different presentations, by P. Makarawate, N. Chaosuwannakit, J. Chindaprasirt, et al (Case Reports in Oncological Medicine, 2013).

The study

• Authors: P. Makarawate, N. Chaosuwannakit, J. Chindaprasirt, P. Ungarreevittaya, S. Chaiwiriyakul, K. Wirasorn, C. Kuptarnond, K. Sawanyawisuth
• Journal: Case Reports in Oncological Medicine
• Published: 2013;2013:356901
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Malignant mesothelioma of the pericardium is a rare and fatal condition that clinicians should be aware of due to its variability of clinical manifestation. The diagnosis may be delayed as a result of delayed treatment. Here, we report two cases of malignant pericardial mesothelioma with two different clinical aspects: cardiac tamponade and mimic tuberculous pericarditis. Both patients: may have indirect exposure to asbestos. Despite chemotherapy, both patients died at 2 weeks and 3 months after the diagnosis. Malignant mesothelioma of the pericardium is fatal, has a variety of presentation, and may not be related to asbestosis exposure.

In plain English

This article was a case report of two men in Thailand with malignant mesothelioma of the pericardium, the sac around the heart. The first, aged 57 and a road construction worker for 15 years, arrived in August 2011 with breathlessness and signs of early cardiac tamponade (fluid pressing on the heart). His tumor was the biphasic type. The second man, aged 27 in the text and 26 in the table, was treated for tuberculous pericarditis for four months before the tumor was found. It had spread to a mediastinal lymph node. Neither man had a history of direct asbestos exposure. The authors wrote that both may have had indirect exposure from road construction and car wheel construction work. No fiber type was named. Both men received pemetrexed and cisplatin. The first survived 3 months and the second 2 weeks. The authors concluded that pericardial mesothelioma is fatal, presents in varied ways and may not be related to asbestos exposure. They also wrote that the role of asbestos in this tumor is unclear. They also concluded that enhanced pericardial nodules on CT may be a clue to diagnosis.

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 (two cases)
• Who was studied: Two men treated at the authors' hospital in Thailand: a 57-year-old transferred in August 2011, and a man aged 27 in the text (26 in Table 1)
• Exposure: No history of direct asbestos exposure. Possible indirect exposure through work: the first man had worked as a road construction worker for 15 years in Lampang province, and the second worked in car wheel construction. No fiber type or dose was given.
• Main results:
  • Case 1: tissue tests led to a diagnosis of pericardial mesothelioma, biphasic type
  • Case 1: after 4 cycles of pemetrexed and cisplatin, the patient refused further treatment and died at home three months later
  • Case 2: the patient was first treated as having tuberculous pericarditis. He was transferred after four months of antituberculous therapy because the fluid around the heart increased.
  • Case 2: a mediastinal lymph node showed tumor spread
  • Case 2: the patient developed a pulmonary embolism two weeks later and died of sudden cardiac arrest during chemotherapy with cisplatin and pemetrexed. Table 1 gives his survival as 2 weeks.
  • Both patients had enhanced nodular lesions of the pericardium and tested positive for the mesothelial markers calretinin and CK5/6
  • The authors described the results of cisplatin and pemetrexed in both patients as not impressive
  • The authors wrote that the role of asbestos in pericardial mesothelioma is unclear
  • The authors suggested asbestos may not have caused the second patient's disease because of his young age
  • The authors reported 60 patients diagnosed with mesothelioma from January 1993 to September 2012, with a pericardial mesothelioma rate of 3.33%. The article does not state where these patients were diagnosed.
• The authors' conclusion: The authors concluded that malignant mesothelioma of the pericardium is fatal, presents in varied ways, and may not be related to asbestos exposure (their words: 'asbestosis exposure'). In their discussion they wrote that the role of asbestos in this tumor is unclear. They also concluded that enhanced soft tissue nodules infiltrating the pericardium on CT may be a clue for diagnosis.

Topics

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

Related studies

• Primary tumors and cysts of the heart and pericardium — H.A. McAllister (1979)
• Epidemiology of mesothelioma of the pericardium and tunica vaginalis testis — G. Mezei, E.T. Chang, et al. (2017)
• Primary malignant mesothelioma of the pericardium. Case report and literature review — R. Thomason, W. Schlegel, et al. (1994)
• Malignant mesothelioma arising after direct application of asbestos and fiber glass to the pericardium — A. Churg, M.L. Warnock, et al. (1978)
• Primary malignant mesothelioma of the pericardium — J. Patel, M.N. Sheppard (2011)
• Malignancies involving the pericardium — W.H. Warren (2000)

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