Neoplastic Pericardial Disease

Our plain-English summary of Neoplastic Pericardial Disease, by J.J. Maleszewski, N.S. Anavekar (Cardiology Clinics, 2017).

The study

• Authors: J.J. Maleszewski, N.S. Anavekar
• Journal: Cardiology Clinics
• Published: 2017;35(4):589-600
• Type of article: Review
• Cited by: 18 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Pericardial tumors are rare lesions that include a range of neoplastic conditions that may arise within the pericardium or metastasize to involve it secondarily. Understanding the spectrum of lesions that are included in the differential diagnosis of a pericardial mass-lesion is critical to making timely, accurate diagnoses and getting the appropriate therapy should one be necessary. This review summarizes the radiologic and pathologic findings of the most commonly encountered of these entities.

Copyright © 2017 Elsevier Inc. All rights reserved.

In plain English

This article was a review, not an original study. The authors described the range of tumors that involve the pericardium, the sac around the heart, covering how each looks on imaging and under the microscope. The review stated that cancers spreading to the pericardium from elsewhere are much more common than tumors that start there. Asbestos was discussed only in the section on malignant mesothelioma of the pericardium. Citing earlier published reports, the authors wrote that pericardial mesotheliomas account for less than 2% of mesothelioma cases. They also wrote that, unlike pleural mesothelioma, these tumors do not share the tight association with asbestos exposure, with only 14% of cases reporting a history of such exposure. No fiber types were named. The authors wrote that diagnosis requires showing tissue invasion and ruling out spread from the pleura, and that surgery is rarely curative. They added that newer chemotherapy has not been studied for this tumor because it is so rare. The authors concluded that imaging helps narrow the possible diagnoses, but most primary pericardial tumors need tissue sampling to be diagnosed.

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: narrative review of the radiologic and pathologic features of tumors of the pericardium
• Who was studied: No study population; the review covers primary (benign and malignant) and secondary (metastatic) pericardial tumors described in the published literature, illustrated with imaging and pathology examples
• Exposure: No exposure was studied. Asbestos exposure is mentioned only in the pericardial mesothelioma section, citing earlier literature; no fiber type, product, job or dose is given
• Main results:
  • Citing earlier work, the review stated that metastatic lesions to the heart or pericardium are estimated to be more than 100 times more common than primary tumors
  • Citing an earlier report, the review stated that pericardial mesotheliomas account for less than 2% of mesothelioma cases
  • Malignant mesothelioma was described as the most common primary malignancy of the pericardium, but as less than 5% of all primary pericardial tumors
  • Citing earlier reports, the review stated that only 14% of pericardial mesothelioma cases reported a history of asbestos exposure, unlike pleural mesothelioma
  • To be called pericardial in origin, a mesothelioma requires careful examination to exclude spread from the pleura, and diagnosis requires demonstrating tissue invasion
  • For pericardial mesothelioma, surgical resection was described as rarely curative
  • For malignant pericardial effusion from any cancer, median survival was described as approximately 5 to 8 months, depending on cancer type and treatment
• The authors' conclusion: The authors concluded that imaging plays a critical role in characterizing pericardial masses and narrowing the differential diagnosis, but that in most cases a primary pericardial tumor requires tissue sampling and remains a pathologic diagnosis
• Limitations the authors state:
  • The authors noted that the use of newer chemotherapy in pericardial mesothelioma has not been studied because the tumor is so rare
  • Non-neoplastic conditions are mentioned only briefly

Topics

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

Medical terms in this study, explained in our Lexicon: Pericardial, Pericardium, Metastasis, Differential Diagnosis.

Related studies

• Surgery for primary intrapericardial tumors in adults — S. Taguchi, R. Yozu (2013)
• Primary sarcomatoid malignant pericardial mesothelioma — D. Jiang, M. Kong, et al. (2013)
• Primary tumors and cysts of the heart and pericardium — H.A. McAllister (1979)
• Surgical pathology of primary cardiac and pericardial tumors — C. Basso, M. Valente, et al. (1997)
• Pericardial Mesothelioma in a 35-Year-Old Male With Ulcerative Colitis — J. Iliff, N.K. Bart, et al. (2019)
• Pericardial mesothelioma — J. Webb, Y.W. Yiu, et al. (2016)

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