Pericardial Mesothelioma, Pericardial Effusion & Pericardial Masses
Pericardial Mesothelioma is a tumor that can occur at any age with a mean age of 46 years at presentation. Patients present with chest pain, dyspnea, cough, and palpitations. Although there appears to be a strong link to asbestos exposure, a definite association has not been established due to the rarity of this lesion.Surgery combined with radiation therapy may provide some palliation, but the prognosis is extremely poor. On CT there is irregular, diffuse pericardial thickening and a pericardial effusion. Pericardium is a thin lining of tissue surrounding the heart.
Pericardial effusion is the collection of fluid in the sac that surrounds the heart, a possible sign of cancer as well as many other conditions. When it is caused by cancer, it can be result of either direct spread of cancer from adjacent organs like the lung, or by metastatic spread from other parts of the body.
The most common primary mass is a congenital
celomic cyst. Benign and malignant pericardial solid masses are equally
common. Teratoma and malignant mesothelioma are the leading primary solid
masses. Secondary malignancies are far more common than primary with seventy
percent due to spread from lung, breast and lymphoproliferative disorders.
Although primary tumors more commonly affect the myocardium than the pericardium
the reverse is true of secondary tumors. In those with pericardial metastases
25% have reduced cardiac function and for the majority tamponade is the
commonest cause of death.
PERICARDIAL MESOTHELIOMA – CASE STUDY
Primary pericardial mesothelioma: