Primary pericardial mesothelioma and asbestos exposure: a rare fatal disease

Our plain-English summary of Primary pericardial mesothelioma and asbestos exposure: a rare fatal disease, by D.M.M. Freitas, R.L. Ramos, L. Serpa Pinto, et al (BMJ Case Reports, 2017).

The study

• Authors: D.M.M. Freitas, R.L. Ramos, L. Serpa Pinto, R. Ribeiro
• Journal: BMJ Case Reports
• Published: 2017;2017
• Type of article: Case report
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Summary of the article

This short 'Images In' case report from internal medicine physicians at a hospital in Porto, Portugal, described a 73-year-old woman with no history of cardiovascular disease. She was admitted with several weeks of worsening breathlessness on exertion, swelling of both legs, breathlessness when lying flat and breathlessness waking her at night. For 50 years she had lived a few metres from a badly preserved building containing asbestos. Probrain natriuretic peptide was 2304 pg/mL. A chest radiograph showed a globular heart shadow and a small transudative pleural effusion; cytology of the pleural fluid found benign mesothelial cells. Echocardiography showed a large pericardial effusion with diastolic collapse of the right ventricle and a 4×1.6 cm mass attached to the visceral pericardium. Fluid drained from the pericardium contained malignant cells of inconclusive origin. CT, mammography and endoscopies found no disease outside the heart. PET-CT showed isolated uptake in the apex and right atrium. The effusion recurred, and pericardiectomy was performed four days after admission. Histology showed primary pericardial malignant mesothelioma. She was treated with carboplatin and pemetrexed, her disease progressed, and she died one year after diagnosis. The authors noted that this tumour is extremely rare and uniformly fatal. They emphasised her asbestos exposure, stating that this association remains controversial and has rarely been reported without concomitant pleural disease.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This short case report (an "Images In" article) describes one patient, a 73-year-old woman with no history of heart disease. She was admitted to hospital with weeks of worsening breathlessness on exertion and swelling of both legs. The authors reported that for 50 years she had lived a few metres from a badly preserved building containing asbestos. The article does not name the type of asbestos fiber or mention any work exposure. A heart ultrasound showed a large build-up of fluid around the heart and a 4 by 1.6 cm mass attached to the heart's outer lining (the pericardium). Fluid drained from around the heart contained malignant cells of unclear origin. Scans and other tests found no disease outside the heart. When the fluid returned, the pericardium was surgically removed, and tissue examination showed primary pericardial malignant mesothelioma. She was treated with carboplatin and pemetrexed, the disease progressed, and she died one year after diagnosis. The authors highlighted her asbestos exposure and noted that the link between asbestos and this cancer remains controversial in the medical literature.

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 (single patient, "Images In" format)
• Who was studied: One 73-year-old woman with no history of cardiovascular disease, admitted to hospital. The authors are from Internal Medicine, Hospital Geral de Santo Antonio, Porto, Portugal. No dates of care are given.
• Exposure: Environmental (residential) exposure: she lived for 50 years a few metres from a badly preserved building containing asbestos. Fiber type and dose are not stated.
• Main results:
  • Echocardiogram showed a large pericardial effusion and a 4×1.6 cm mass attached to the visceral pericardium in the right apex.
  • Fluid drained from around the heart contained malignant cells of inconclusive origin.
  • A small pleural effusion contained benign mesothelial cells.
  • CT, mammography and endoscopies found no disease outside the heart.
  • After pericardiectomy, histology showed primary pericardial malignant mesothelioma.
  • She was treated with carboplatin and pemetrexed, the disease progressed, and she died 1 year after diagnosis.
• The authors' conclusion: The authors emphasised the patient's asbestos exposure. They stated that the association between asbestos and primary pericardial mesothelioma remains controversial in the literature and has rarely been reported without accompanying pleural disease.

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 Mesothelioma, Asbestos Exposure, Chest X-Ray, Pleural Effusion, Cytology, Mesothelial Cells, Pericardial Effusion, Pericardium.

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• The IASLC Mesothelioma Staging Project: Improving Staging of a Rare Disease Through International Participation — H. Pass, D. Giroux, et al. (2016)
• Malignant peritoneal mesothelioma in a 16-year-old girl: presentation of a rare disease — I.B. Brecht, A. Agaimy, et al. (2012)
• The Challenge of Defining Treatment Standards for a Rare Disease: Malignant Peritoneal Mesothelioma — H.L. Kindler (2016)
• Pericardial mesothelioma presenting as left atrial thrombus in a patient with mitral stenosis — Y. Miyamoto, S. Nakano, et al. (1996)
• Successful palliation for an aged patient with primary pericardial mesothelioma — R. Isoda, H. Yamane, et al. (2015)

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