Unexpected malignant pericardial mesothelioma presenting as pericardial constriction

Our plain-English summary of Unexpected malignant pericardial mesothelioma presenting as pericardial constriction, by M. Oc, B. Oc, R. Dogan (Bratislavské Lekárske Listy, 2012).

The study

• Authors: M. Oc, B. Oc, R. Dogan
• Journal: Bratislavské Lekárske Listy
• Published: 2012;113(10):620-1
• Type of article: Case report
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Pericardial mesothelioma is a rare and highly aggressive and lethal cardiac tumour. A 25-year-old male patient who was complaining of fever, night sweats, shortness of breath and palpitations after an upper respiratory system infection was admitted in May 2008. He had a history of 12 years exposure to asbestos. When the patient was referred to our hospital in June 2008, his complaints of palpitations and shortness of breath were continuing. He had oedema of legs and a venous swelling on his neck. The echocardiography showed pericardial effusion and pericardial thickening which were also found on the CT. Through median sternotomy a pericardectomy and tumor resection were performed. Histological and immunohistochemical findings lead to the diagnosis of malignant pericardial mesothelioma. In conclusion, there is still not a radical therapy for primary pericardial mesothelioma. Surgery is done to prevent cardiac tamponade and relieves constriction (Fig. 1, Ref. 12).

In plain English

This case report from a private hospital in Ankara, Turkey, described one 25-year-old man. In May 2008, after an upper respiratory infection, he was admitted with fever, night sweats, shortness of breath and palpitations. The report stated he had a 12-year history of exposure to asbestos but did not give the fiber type or how he was exposed. When fluid built up around his heart and pressed on it (tamponade), doctors drained 700 ml of bloody fluid. Tests of the fluid found no cancer, but a biopsy of the sac around the heart (the pericardium) showed a malignant tumor. Surgeons removed as much of the pericardium and tumor as possible. The pericardium was 2–3 cm thick and stuck firmly to the heart muscle. Tissue examination and immunohistochemical staining led to a diagnosis of malignant pericardial mesothelioma. He was discharged a week after the operation. The authors concluded that there is still no radical therapy for primary pericardial mesothelioma, and that surgery is done to prevent tamponade and relieve constriction.

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 (one patient)
• Who was studied: One 25-year-old man, admitted in May 2008 and referred in June 2008 to the authors' hospital (29 May Private Hospital, Ankara, Turkey)
• Exposure: A 12-year history of asbestos exposure. The fiber type, job and source of exposure were not stated.
• Main results:
  • During his first hospital stay, fluid around the heart increased and caused tamponade. 700 ml of hemorrhagic (bloody) pericardial fluid was drained.
  • Cytology of the fluid showed no malignancy, but the pericardial biopsy showed infiltration by a low-differentiated malignant tumor.
  • Echocardiography, confirmed on CT, showed pericardial effusion and pericardial thickening.
  • Blood tests showed reactive inflammation (C-reactive protein 87.3 mg/L). The authors also reported liver dysfunction, based on lactate dehydrogenase.
  • At surgery (median sternotomy, pericardiectomy and tumor resection), the pericardium was 2–3 cm thick, white, homogeneous and very strongly adherent to the heart muscle.
  • Tumor cells stained positive for pankeratin, CK17, LMW keratin and calretinin. Together with the histological findings, this led to the diagnosis of malignant pericardial mesothelioma.
  • The patient was discharged a week after the operation, with his complaints treated.
• The authors' conclusion: The authors concluded that there is still no radical therapy for primary pericardial mesothelioma, that surgery is done to prevent cardiac tamponade and relieve constriction, and that early diagnosis and surgery may prolong survival in some patients.

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, Pericardial, Pericardial Effusion, Cardiac Tamponade.

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• Cardiac tamponade as the initial manifestation of primary pericardial mesothelioma — M. Stein, A. Neuman, et al. (1995)
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