Malignant pericardial mesothelioma. Report of two cases, review of the literature and differential diagnosis

Our plain-English summary of Malignant pericardial mesothelioma. Report of two cases, review of the literature and differential diagnosis, by M. Papi, G. Genestreti, D. Tassinari, et al (Tumori, 2005).

The study

• Authors: M. Papi, G. Genestreti, D. Tassinari, P. Lorenzini, S. Serra, M. Ricci, E. Pasquini, M. Nicolini, G. Pasini, E. Tamburini, P.P. Fattori, A. Ravaioli
• Journal: Tumori
• Published: 2005;91(3):276-9
• Type of article: Case report, Review
• Cited by: 27 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant pericardial mesothelioma is an uncommon variety of a primary malignant cardio-pericardial tumor and it is a highly lethal and fortunately rare cardiac neoplasm. The presentation of pericardial mesothelioma is aspecific and pathologically mesothelioma is not the most common among primary tumors of the pericardium. It is characterized by atypical solid growth of mesothelium with formation of atypical cavities surrounded by fibrous stroma. Antemortem diagnosis is difficult and distant metastases are extremely rare. Radical surgery can be used to treat localized mesothelioma. The treatment for advanced primary pericardial mesothelioma is usually palliative because the tumor is resistant to radiotherapy and chemotherapy. The prognosis is unfavorable. The median survival from the onset of symptoms is six months. In this paper we report two cases of patients with primary mesothelioma of the pericardium without a definite history of asbestos exposure.

In plain English

This article was a report of two patients with malignant pericardial mesothelioma, a cancer of the sac around the heart, along with a discussion of earlier published work. The authors stated that neither patient had a definite history of asbestos exposure. The first patient was a 68-year-old retired man and former smoker. About 1000 mL of bloody fluid was drained from around his heart and contained tumor cells of unknown origin. After a heart attack he had part of the pericardium removed, and tissue examination showed epithelial mesothelioma. His condition worsened rapidly and he died. The second patient was a 44-year-old male painter who smoked about 30 cigarettes a day. About 1100 mL of bloody fluid was drained from around his heart, and no abnormal cells were found in it. A later biopsy taken during chest surgery showed biphasic mesothelioma, which was confirmed at autopsy. He died in intensive care. In their discussion, the authors wrote that the role of asbestos in pericardial mesothelioma is unclear.

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) with discussion of the literature
• Who was studied: Two men with primary pericardial mesothelioma, seen in 1997 and 1998: a 68-year-old retired former smoker and a 44-year-old male painter who was a current smoker
• Exposure: Neither patient had a definite history of asbestos exposure. No fiber types or exposure doses were described.
• Main results:
  • Case 1: about 1000 mL of hemorrhagic pericardial fluid was drained. Cytology showed epithelial tumor cells of unknown origin.
  • Case 1: after an acute myocardial infarct, the patient underwent pericardial resection, and histology showed pericardial mesothelioma.
  • Case 1: the pathological diagnosis was pericardial epithelial mesothelioma. Immunohistochemistry was positive for cytokeratin (AE1/AE3) and calretinin.
  • Case 1: the patient's condition worsened very rapidly and he died.
  • Case 2: a 44-year-old male painter who smoked about 30 cigarettes per day came to the authors' attention in 1998.
  • Case 2: about 1100 mL of hemorrhagic pericardial fluid was drained. Cytology did not show atypical cells.
  • Case 2: a biopsy taken at sternotomy led to a diagnosis of biphasic mesothelioma, sarcomatous in the pericardium, which was confirmed at autopsy.
  • Case 2: after surgery the patient was transferred to the Intensive Care Unit, where he died.
• The authors' conclusion: The authors wrote that the role of asbestos in pericardial mesothelioma is unclear.

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, Differential Diagnosis, Pericardial, Neoplasm, Mesothelioma, Pericardium, Mesothelium, Localized Malignant Mesothelioma.

Related studies

• Pericardial synovial sarcoma, a potential for misdiagnosis: clinicopathologic and molecular cytogenetic analysis of three cases with literature review — Y. Cheng, W. Sheng, et al. (2012)
• A second case of pericardial mesothelioma mimicking systemic lupus erythematosus in the literature in over 30 years: a case report — C. Mensi, A. Romano, et al. (2017)
• Primary pericardial mesothelioma: report of two cases and review of the literature — A.L. Sytman, R.N. MacAlpin (1971)
• Malignant pericardial mesothelioma : A systematic review of current practice — S. Cao, S. Jin, et al. (2018)
• Surgical pathology of primary cardiac and pericardial tumors — C. Basso, M. Valente, et al. (1997)
• Primary pericardial tumors — C.S. Restrepo, D. Vargas, et al. (2013)

Browse more research in Tumori, or return to medical research.