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Case Reports
. 2017 Mar 29;11(1):85.
doi: 10.1186/s13256-017-1237-z.

A second case of pericardial mesothelioma mimicking systemic lupus erythematosus in the literature in over 30 years: a case report

Affiliations
Case Reports

A second case of pericardial mesothelioma mimicking systemic lupus erythematosus in the literature in over 30 years: a case report

Carolina Mensi et al. J Med Case Rep. .

Abstract

Background: Mesothelioma is a rare neoplasm which commonly develops in the pleura of people exposed to asbestos. Pericardial mesothelioma accounts for only 0.7 % of all malignant mesotheliomas and it usually presents with pericardial effusion, mimicking serositis. To date, there are approximately 200 cases of pericardial mesothelioma described in the medical literature, and little knowledge exists about the systemic manifestations of this pathology. The first and only described case of pericardial mesothelioma with autoimmune features dates back to 1984 and, in our case report, we describe the second.

Case presentation: We report a case of a 45-year-old white woman whose pericardial mesothelioma was initially misdiagnosed as pericardial involvement of an autoimmune disease (systemic lupus erythematosus). After several relapses of pericardial effusion, a computed tomography scan and a biopsy with histological analysis were performed revealing neoplastic growth.

Conclusions: We describe a rare case of pericardial mesothelioma in a patient with a clinical presentation compatible with lupus serositis. Clinicians should consider malignant mesothelioma in the differential diagnosis of pericardial effusion, especially when it is recurrent and not clearly explained by other causes. Cytological samples should always be obtained and, if imaging tools are suggestive for solid processes, histological confirmation is mandatory.

Keywords: Asbestos; Case report; Pericardial effusion; Pericardial mesothelioma; Pericarditis; SLE.

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Figures

Fig. 1
Fig. 1
Contrast-enhanced computed tomography of the thorax before (a, b) and after (c, d) chemotherapy. a Axial image crossing the left atrium. b-c Axial images through the ventricles. d Sagittal image through the aortic arch. Before chemotherapy (a, b), both parietal (white arrows) and visceral (black arrow) layers of the pericardium were very thickened. After chemotherapy (c, d), computed tomography shows progression of the lesions around ventricles, in cranial sinuses, around the ascending aorta and the pulmonary artery. Legend: A aorta, CV cava vein, L liver, LA left atrium, LV left ventricle, PL pleural effusion, RV right ventricle, black arrows visceral layer of the pericardium, star neoplastic tissue, white arrows parietal layer of the pericardium

References

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