Primary malignant pericardial mesothelioma with a survival of 2.5 years: a case report

Our plain-English summary of Primary malignant pericardial mesothelioma with a survival of 2.5 years: a case report, by Y. Yan, W. Lv, Y. Luo, et al (Translational Cancer Research, 2022).

The study

• Authors: Y. Yan, W. Lv, Y. Luo, J. Hu, J. Yang
• Journal: Translational Cancer Research
• Published: 2022;11(5):1451-1456
• Type of article: Case report
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Primary malignant pericardial mesothelioma (PMPM) is a highly malignant tumor originating in the pericardium serosum with clinical manifestations presenting as constrictive pericarditis, with pericardial tamponade and heart failure. Malignant pericardial mesothelioma is rare and has a poor prognosis, with an average survival time of 6-10 months.

Case Description: Herein, we report the case of a 57-year-old female who developed chest tightness and panic for no obvious reason. She was diagnosed with tuberculous pericarditis via multiple examinations including positron emission tomography/computed tomography (PET/CT), pleural biochemical routine, tuberculin purified protein derivative (PPD) test, T cell spot (T-SPOT) test, and echocardiography, and was experienced intermittent relief after anti-tuberculosis treatment. On 21 July, 2020, pericardiectomy was performed due to poor therapeutic effect, and the postoperative pathological diagnosis was malignant mesothelioma. After discussing treatment plans and considering the prognosis, the patient opted for palliative care. Subsequently, her symptoms gradually worsened, with chest tightness, shortness of breath, palpitations at rest, frequent arrhythmias, heart failure, cardiogenic shock, and multiple plasma chamber effusions. This case showed that the most common misdiagnosis of PMPM is tuberculous pericarditis, which needs to be differentiated from pleural mesothelioma with pericardial metastasis.

Conclusions: The diagnosis of PMPM is usually made by pathologic surgery or histopathological examination to determine the specific disease location. In addition, pericardiocentesis fluid exfoliation cytology, imaging and echocardiography can assist diagnosis. Due to the lack of effective treatment for PMPM, timely surgery and postoperative adjuvant chemotherapy are needed to improve the quality of life of patients and prolong their survival time.

2022 Translational Cancer Research. All rights reserved.

In plain English

This case report, by authors from a hospital in Guiyang, China, described one 57-year-old woman with primary malignant pericardial mesothelioma, a cancer of the lining around the heart. The patient denied exposure to asbestos, possible viral infection or other harmful substances, and denied what the article calls 'post-radiation' exposure. Chest tightness and panic began in January 2018. A local hospital suspected tuberculous pericarditis, and the patient was given anti-tuberculosis treatment for 1 year. When chest tightness returned in 2020, a PET/CT scan showed a thickened pericardium with multiple nodules, which was read as tending towards tuberculosis. Further anti-tuberculosis treatment did not work well. Part of the pericardium was removed in July 2020, and tissue examination diagnosed malignant mesothelioma. A later chest CT showed multiple metastatic lesions in the lungs. The patient chose palliative care. The authors reported survival of 2.5 years from onset and 1 year after surgery. They attributed the prolonged survival to treatment of complications and supportive care. They noted that only one patient was described and that the cause of the disease in this patient was unclear.

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 (single patient)
• Who was studied: One 57-year-old woman whose symptoms began in January 2018; the authors are from Guiqian International General Hospital, Guiyang, China
• Exposure: No asbestos exposure was reported. As the article reports it, the patient denied exposure to asbestos, 'post-radiation', possible viral infection or other harmful substances.
• Main results:
  • At a local hospital, tuberculous pericarditis was suspected. The patient received anti-tuberculosis treatment for 1 year, which was stopped when symptoms eased.
  • In April 2020, PET/CT showed marked thickening of the pericardium with multiple nodules, interpreted as tending towards tuberculosis.
  • A partial pericardial resection in July 2020 led to a pathological diagnosis of (pericardial) malignant mesothelioma.
  • Chest CT later showed pericardial thickening and multiple metastatic lesions in the lungs.
  • After treatment plans were discussed, the patient chose palliative care.
  • The patient survived 2.5 years from symptom onset and 1 year after surgery.
• The authors' conclusion: The authors concluded that this patient's survival was prolonged by treatment of complications, symptomatic and supportive care, and meticulous care.
• Limitations the authors state:
  • Only one patient was included, and the case may be unique.
  • The cause and risk factors of the disease in this patient are unclear.

Topics

Medical terms in this study, explained in our Lexicon: Pericardial Mesothelioma, Pericardium, Pericardial, Prognosis, Pericardiectomy, Mesothelioma, Palliative Care, Misdiagnosis.

Related studies

• Three-year survival after surgery for primary malignant pericardial mesothelioma: report of a case — K. Fujita, M. Hata, et al. (2014)
• Primary pericardial mesothelioma in a 19-year-old presenting as pericarditis — M.O. Kayatta, S.P. Dineen, et al. (2013)
• Long-term survival from multidisciplinary treatment of primary malignant pericardial mesothelioma: A case report — V.A. Hai, N.T.M. Chau, et al. (2024)
• Sarcomatoid Type Primary Pericardial Mesothelioma with a Long-term Survival after the Onset of Cardiac Tamponade — C. Saisho, H. Ishii, et al. (2016)
• Age and treatment disparities in survival of primary malignant cardiac tumors: an analysis of over 40 years and 500 patients — W. Wang, L. Kang, et al. (2023)
• Case Report: Tislelizumab combined with bevacizumab in the treatment of primary malignant pericardial mesothelioma — Z. Liu, Y. Yan, et al. (2026)

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