Primary pericardial mesothelioma

Our plain-English summary of Primary pericardial mesothelioma, by N.T. Eren, A.R. Akar (Current Treatment Options in Oncology, 2002).

The study

• Authors: N.T. Eren, A.R. Akar
• Journal: Current Treatment Options in Oncology
• Published: 2002;3(5):369-73
• Type of article: Review
• Cited by: 37 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Pericardial mesothelioma is a rare cancer for which treatment options are limited. Operative intervention in pericardial mesothelioma is primarily for effusion control, for cytoreduction before multimodal therapy, or to deliver and monitor innovative intrapericardial therapies. Misdiagnosis is common. Early detection of the disease is the only hope for survival. Echocardiography, pathologic examination of pericardial fluid and pericardial biopsy, Gallium-67 scintigraph, Ber-EP4 antibody, and immunohistochemical procedures can be used. Magnetic resonance imaging is emerging as the best modality for demonstrating the nature and extent of the constrictive process, and the infiltration to the cardiac wall and great vessels. Failure of surgical techniques is usually associated with mesothelioma with entrapped heart, a large solid tumor mass, and a long history of pericardial effusion. If the tumor is localized, resection is the only hope for this rare, but lethal, entity. No single treatment modality is efficient by itself. The exact role of intracavitary chemotherapy or irradiation remains to be defined. Preliminary clinical application of photodynamic therapy and attempts at inhibiting the effects of growth factors, such as vascular endothelial growth factor and platelet-derived growth factor, and vaccine treatments are being explored. Adenoviral molecular chemotherapy recently completed phase I testing. Clinical trials for pleural mesothelioma remain important as clinicians seek to improve the outcome for patients with pericardial mesothelioma. Early diagnosis and multidisciplinary patient care is essential for improved surgical outcome. In the future, combined therapeutic strategies involving radical surgery, radiotherapy, adjuvant chemotherapy, and immunomodulation may have a role in the treatment of pericardial mesotheliomas.

In plain English

This 2002 article from Ankara University's Heart Center was an opinion-based review of primary pericardial mesothelioma, a cancer of the sac around the heart. It reported no new patient data. The authors described the disease as rare, with about 120 reported cases, and stated that median survival from diagnosis is less than 6 months. They noted that surveys had found prior asbestos exposure in about 70% to 80% of patients with pleural and peritoneal mesothelioma. However, they said no definite correlation had been established between asbestos exposure and pericardial mesothelioma. They cited an earlier review documenting asbestos exposure in only 4 of 28 (14%) cases. They suggested that asbestos fibers carried through the lymphatic route could be a reasonable explanation. They also stated that therapeutic radiation has been shown to cause mesotheliomas after 10 to 30 years. Reviewing surgery, sclerotherapy, chemotherapy and experimental therapies, they noted no reported prospective randomized data comparing survival or symptom control across surgery, chemotherapy or supportive care. They concluded that no single treatment is efficient by itself and that early diagnosis and multidisciplinary care are essential.

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 and opinion article (no original data)
• Who was studied: No patients were studied. The article reviewed published reports on primary pericardial mesothelioma, which the authors said accounts for about 6% of mesotheliomas, with about 120 reported cases.
• Exposure: The authors discussed asbestos exposure as a possible cause, without naming fiber types, and said no definite correlation with pericardial mesothelioma had been established. They also discussed therapeutic radiation as a cause of mesothelioma.
• Main results:
  • The authors stated that epidemiologic surveys (other studies) found prior asbestos exposure in about 70% to 80% of patients with pleural and peritoneal mesotheliomas.
  • The authors cited a review by Thomason et al. of 28 English-language cases from 1972 through 1992. It documented asbestos exposure in 4 of 28 (14%) pericardial mesothelioma patients.
  • The authors suggested that the lymphatic route, shown to move asbestos fibers from the lung to other parts of the body, could be a reasonable explanation for pericardial mesotheliomas.
  • The authors stated that therapeutic radiation has been shown to cause mesotheliomas after a latent period of 10 to 30 years.
  • The authors stated that median survival from diagnosis is less than 6 months.
  • The authors stated there were no reported prospective randomized data comparing survival or symptom control in patients treated with surgery, chemotherapy or supportive care.
• The authors' conclusion: The authors concluded that no single treatment modality is efficient by itself, and that early diagnosis and multidisciplinary care are essential for improved surgical outcome.

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, Cytoreductive Surgery, Multimodal Therapy, Misdiagnosis, Pericardial, Biopsy, Ber-EP4, Mesothelioma.

Related studies

• 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)
• Primary pericardial mesothelioma: report of two cases and review of the literature — A.L. Sytman, R.N. MacAlpin (1971)
• A case of primary pericardial mesothelioma detected by 18F-FDG PET/CT — F. Aga, Y. Yamamoto, et al. (2012)
• Primary pericardial mesothelioma in a 19-year-old presenting as pericarditis — M.O. Kayatta, S.P. Dineen, et al. (2013)
• Primary sarcomatoid malignant pericardial mesothelioma — D. Jiang, M. Kong, et al. (2013)

Browse more research in Current Treatment Options in Oncology, or return to medical research.