Primary sarcomatoid malignant mesothelioma of the pericardium

Our plain-English summary of Primary sarcomatoid malignant mesothelioma of the pericardium, by T. Terada (Medical Oncology, 2012).

The study

• Author: T. Terada
• Journal: Medical Oncology
• Published: 2012;29(2):1345-6
• Type of article: Case report, Letter
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

This letter to the editor described a case of primary sarcomatoid malignant mesothelioma of the pericardium, a very rare tumour. The author noted that pericardial mesothelioma accounts for 0.7% of all malignant mesotheliomas and that about 150 cases had been reported. A 64-year-old Japanese man came to the author's hospital with shortness of breath. Imaging, including ultrasound and CT, showed pericardial effusion and diffuse thickening of the pericardium. He had no history of asbestos exposure. Open pericardial biopsy showed a wall 1.2 cm thick, with proliferation of atypical spindle cells invading fat tissue, scattered mitotic figures and no epithelioid element. On immunohistochemistry the tumour cells were positive for pancytokeratin (KL-1), calretinin, cytokeratin 5/6 and vimentin. They were negative for EMA, CEA, MOC31, Ber-EP4, Leu M1, HBME1, CD34, S100 protein, desmin, B72.3 and other markers. WT-1 was not examined. Imaging showed no other tumours in the body, and sarcomatoid mesothelioma of the pericardium was diagnosed. The author discussed differential diagnoses, including solitary fibrous tumour, germ cell neoplasm, metastatic tumours and synovial sarcoma, and considered the diagnosis correct. The patient was treated with chemoradiation but died of cardiac failure 9 months after first presentation. The author stated that the prognosis of primary pericardial mesothelioma is very poor and that most patients die within 1 year.

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 letter to the editor described one patient. A 64-year-old Japanese man came to the author's hospital with shortness of breath. Imaging showed fluid around the heart and diffuse thickening of the pericardium, the sac that surrounds the heart. He did not have a history of asbestos exposure. A biopsy of the pericardium, whose wall was 1.2 cm thick, showed abnormal spindle-shaped cells invading fat tissue, and no epithelioid element was seen. Laboratory staining found the tumor cells positive for pancytokeratin, calretinin, cytokeratin 5/6 and vimentin, and negative for a long list of other markers. The diagnosis was sarcomatoid mesothelioma of the pericardium, and imaging found no other tumors in the body. He was treated with chemoradiation but died of cardiac failure 9 months after the illness first appeared. Another marker, WT-1, was not tested. The author concluded that the diagnosis of primary sarcomatoid pericardial mesothelioma seemed correct and noted that this type is very rare. Because this is a report of one patient, it does not show how often the disease occurs.

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), published as a letter to the editor
• Who was studied: One 64-year-old Japanese man seen at the author's hospital (Shizuoka City Shimizu Hospital, Japan) for shortness of breath
• Exposure: The patient had no history of asbestos exposure
• Main results:
  • Imaging showed pericardial effusion (fluid around the heart) and diffuse thickening of the pericardium
  • The open pericardial biopsy had a wall thickness of 1.2 cm and showed atypical spindle cells invading fat tissue, with no epithelioid element
  • Tumor cells were positive for pancytokeratin (KL-1), calretinin, cytokeratin 5/6 and vimentin, and negative for markers including EMA, CEA, MOC31, Ber-EP4, Leu M1, HBME1, CD34 and B72.3
  • Sarcomatoid mesothelioma of the pericardium was diagnosed, and imaging showed no other tumors in the body
  • The patient was treated with chemoradiation and died of cardiac failure 9 months after the first manifestation
• The authors' conclusion: The author concluded that the diagnosis of primary sarcomatoid pericardial mesothelioma seemed correct, based on positive calretinin and cytokeratin 5/6 and negative CEA, Ber-EP4, MOC31, LeuM1 and B72.3, and noted that the sarcomatoid type of pericardial mesothelioma is very rare
• Limitations the authors state:
  • The marker WT-1, which the author describes as a specific and sensitive marker of mesothelioma, was not examined in this case

Topics

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

Medical terms in this study, explained in our Lexicon: Sarcomatoid, Malignant Mesothelioma, Pericardium, Pericardial Mesothelioma, Ultrasound, Pericardial Effusion, Asbestos Exposure, Pericardial.

Related studies

• Primary sarcomatoid malignant pericardial mesothelioma — D. Jiang, M. Kong, et al. (2013)
• Primary malignant sarcomatoid mesothelioma in the pericardium — K. Tateishi, M. Ikeda, et al. (2013)
• Primary malignant mesothelioma of the pericardium — J. Patel, M.N. Sheppard (2011)
• Primary tumors and cysts of the heart and pericardium — H.A. McAllister (1979)
• Primary malignant mesothelioma of the pericardium. Case report and literature review — R. Thomason, W. Schlegel, et al. (1994)
• Malignant mesothelioma of the pericardium: case reports and immunohistochemical studies including Ki-67 expression — H. Hirano, T. Maeda, et al. (2002)

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