Korean J Thorac Cardiovasc Surg.  2010 Aug;43(4):437-440.

Surgical Experience of Pericardial Mesothelioma: 2 Cases

• Bang JH
• Woo JS
• Choi PJ
• Park KJ
• Jeong SS
• Hong SH
• Roh MS

Abstract

Cardiac mesotheliomas are rare. It is difficult to diagnose them at an early stage because the symptoms are nonspecific. Here we report two cases that had been initially diagnosed as constrictive pericarditis but later were definitively diagnosed, after pericardiectomy, as mesothelioma. The two patients complained of dyspnea that lasted 4 months and 10 years. Chest CT showed mild pericardial effusion and thickened pericardium, which was found enveloping the heart without any lumps. Median sternotomy showed that the overall pericardium was thickened by more than 10 mm. Pericardiectomy (phrenic nerve to phrenic nerve) was performed and post-operative histology confirmed malignant mesothelioma. In one patient the disease recurred near the pericardium post-operatively at 7 months and the patient died at 11 months. The other patient received chemotherapy and was still alive at post-operative month 16. Pericardial mesothelioma is an extremely rare disease exhibiting clinical signs similar to those of constrictive pericarditis, and should be diagnosed at an early stage of onset.

Keyword

Mesothelioma; Constrictive pericarditis; Pericardiectomy

MeSH Terms

Dyspnea
Heart
Humans
Mesothelioma
Pericardial Effusion
Pericardiectomy
Pericarditis, Constrictive
Pericardium
Rare Diseases
Sternotomy
Thorax