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. 2013:2013:283601.
doi: 10.1155/2013/283601. Epub 2013 Jun 13.

Primary pericardial mesothelioma: a rare entity

Mohit Godar  1 , Jianhua Liu, Pengguo Zhang, Yang Xia, Qinghai Yuan
Affiliations

Primary pericardial mesothelioma: a rare entity

Mohit Godar et al. Case Rep Oncol Med. 2013.

Abstract

Primary pericardial malignant mesothelioma is an extremely rare neoplasm that arises from the pericardial mesothelial cell layers. Clinical symptoms and signs are frequently nonspecific, and the diagnosis is usually made after surgery or at autopsy. There is no standard treatment for pericardial mesothelioma; nonetheless, radical surgery is the mainstay of therapy for localized disease. The neoplasm is highly aggressive and carries a dismal prognosis with an overall survival of less than six months. This paper presents a case study of a 68-year-old patient with a primary pericardial malignant mesothelioma. Radiologic evaluation revealed a small nodule in the posterior pericardium with pericardial and bilateral pleural effusions. The diagnosis was established after surgery by histological and immunohistochemical studies. The patient remained alive and free of disease for about 24 months; however, due to rapid local recurrence, the patient died 27 months after the surgical treatment.

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Figures

Figure 1
Figure 1
(a) Computed tomography (CT) scanogram/scout shows enlarged cardiac silhouette with blunting of the left costophrenic sulcus. (b) Nonenhanced chest CT image reveals a nearly isoattenuating nodular mass arising from the left posterior pericardial wall (arrow) with a large circumferential pericardial effusion (asterisks) and bilateral pleural effusions without signs of cardiac tamponade. (c) Contrast-enhanced chest CT scan shows a well-defined, enhancing nodule (arrow).
Figure 2
Figure 2
Histopathologic examination of postpericardiectomy specimen reveals abundant pleomorphic malignant cells with epithelial appearance (hematoxylin and eosin, ×100).
Figure 3
Figure 3
The tumor cells are strongly and diffusely positive for vimentin (a), calretinin (b), CK AE1/AE3 (c), and CK7 (d), with focal patchy immunoreactivity for HBME-1 (e) and CK 5/6 (f). (×200).
Figure 4
Figure 4
Anteroposterior chest radiograph on the first postoperative day shows a decrease in cardiac silhouette with increased lung markings.
See this image and copyright information in PMC

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