Pericardial mesothelioma and asbestos exposure

Our plain-English summary of Pericardial mesothelioma and asbestos exposure, by C. Mensi, S. Giacomini, C. Sieno, et al (International Journal of Hygiene and Environmental Health, 2011).

The study

• Authors: C. Mensi, S. Giacomini, C. Sieno, D. Consonni, L. Riboldi
• Journal: International Journal of Hygiene and Environmental Health
• Published: 2011;214(3):276-9
• Type of article: Case report
• Cited by: 30 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Pericardial mesothelioma (PM) accounts for 0.7% of all malignant mesotheliomas. Although asbestos exposure is a recognized etiological factor for pleural and peritoneal mesotheliomas, its role in the development of PM is controversial. The aim of this study is to describe the characteristics of PM cases occurred in Lombardy, a highly industrialized Region of Northern Italy. From the Lombardy Mesothelioma Registry we selected the incident cases of PM registered in the Lombardy Region between 2000 and 2009 and we abstracted clinical characteristics and history of asbestos exposure. We identified 8 cases (6 men and 2 women), with a median age at diagnosis of 55.5 years, representing 0.3% of all mesothelioma cases (n = 3059). The age-standardized incidence rate was 0.09 per million/year. Occupational exposure to asbestos was documented in 5 of the 7 cases for which we obtained an interview. Our findings support the role of asbestos in the pathogenesis of PM.

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In plain English

This short communication described the pericardial mesothelioma cases (cancer of the lining around the heart) recorded by the Lombardy Mesothelioma Registry, Northern Italy, in 2000–2009. There were 8 cases (6 men, 2 women), 0.3% (95% CI 0.1–0.5) of the 3059 mesotheliomas of all sites registered. Age-standardized incidence was 0.15 per million per year in men and 0.04 in women. Median age at diagnosis was 55.5 years (range 22–87), against 68 years for the registry's pleural mesothelioma cases. An exposure questionnaire was completed by the patient or next of kin for 7 cases. Occupational asbestos exposure was documented in 5 of these 7 (71.4%, 95% CI 29.0–96.3). Three were classed as certain (a firefighter, a metal caster, a paper-mill calenderer) and two as possible (a bricklayer; a shirtmaker who later farmed). For a postal clerk and a 22-year-old man, exposure was classed as unknown. Median time since first exposure was 56 years. The authors concluded that their findings support a role for asbestos in the development of pericardial mesothelioma.

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 series drawn from a population-based mesothelioma registry (published as a short communication)
• Who was studied: 8 incident cases of pericardial mesothelioma (6 men, 2 women) recorded in 2000–2009 by the Lombardy Mesothelioma Registry, which covers residents of the Lombardy region of Northern Italy (population 9.1 million). These were 0.3% (95% CI 0.1–0.5) of 3059 mesothelioma cases of all sites.
• Exposure: Asbestos exposure assessed by a standardized questionnaire (occupational, residential, lifestyle and household history) given by trained interviewers to the patient or next of kin, then reviewed by an expert panel. Jobs included firefighter, metal caster, paper-mill calenderer, bricklayer, shirtmaker/vegetable farmer, postal clerk. The article did not name specific fiber types.
• Main results:
  • Age-standardized incidence rates were 0.15 per million per year for males and 0.04 for females
  • The overall regional age-standardized incidence rate was 0.09 per million per year
  • Median (mean) age at diagnosis of the pericardial cases was 55.5 (58.2) years, range 22–87. This was lower than the median age of 68 years among the registry's 2897 pleural mesothelioma cases.
  • Clinical onset was pericardial effusion in 6 patients and pericarditis in 3 patients (1 patient had both)
  • Mean survival was 284 days and median survival 117 days. One patient was alive 1094 days after diagnosis.
  • A standardized questionnaire was completed for 7 of the 8 cases
  • Occupational asbestos exposure was documented in 5 of the 7 interviewed cases (71.4%, 95% CI 29.0–96.3)
  • Three cases were classified as occupational/certain exposure: a firefighter, a metal caster and a calenderer in a paper mill (Table 1)
  • Two cases were classified as occupational/possible exposure (Table 1). One was a bricklayer, with no other detailed information available. The other was a shirtmaker and later vegetable farmer who used recycled jute sacks.
  • Median latency (time since first exposure) was 56 years
  • In 2 cases (a postal clerk and a 22-year-old former apprentice mechanic and bricklayer) exposure was classified as unknown
• The authors' conclusion: The authors concluded that they documented asbestos exposure in most cases despite the rarity of the disease, and that their findings support the role of asbestos in the pathogenesis of pericardial mesothelioma

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, Asbestos Exposure, Malignant Mesothelioma, Peritoneal Mesothelioma, Mesothelioma, Incidence, Occupational Exposure.

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• Primary malignant pericardial mesothelioma mimicking pericardial metastasis from adenocarcinoma — M. Horie, S. Noguchi, et al. (2010)
• Association between asbestos exposure and pericardial and tunica vaginalis testis malignant mesothelioma: a case-control study and epidemiological remarks — A. Marinaccio, D. Consonni, et al. (2020)
• Surgical pathology of primary cardiac and pericardial tumors — C. Basso, M. Valente, et al. (1997)
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