Echocardiographic characteristics of primary malignant pericardial mesothelioma and outcomes analysis: a retrospective study

Abstract

BackgroundLittle is known about the echocardiographic characteristics of primary malignant pericardial mesothelioma (PPM) due to its rarity. The aim of this study was to explore the sex-specific echocardiographic patterns of PPM and risk factors for in-hospital mortality.MethodsA retrospective information retrieval was conducted for cases of PPM reported from China during 1981 and 2015. The diagnosis was made by histopathological examinations and only cases with echocardiographic descriptions were included. Data on the clinical and echocardiographic findings were collected. Difference in clinical, sex-specific echocardiographic characteristics and findings across different time periods were assessed. Logistic regression analysis was performed to explore echocardiographic risk factors for in-hospital mortality.ResultsA total of 64 patients with PPM were included, with a mean age of 39.2 ± 15.6 years and minor male dominance (40, 62.5%). The most common echocardiographic presentations were pericardial effusion (55, 85.9%), pericardial masses (36.4%) and thickening (17.3%), respectively. The positive rate of pericardiocentesis was only 20.9%. Six patients (15.4%) died among 39 cases reporting in-hospital outcome. Logistics analysis identified no clinical or echocardiographic parameters associated with in-hospital mortality (all P > 0.05).ConclusionsThe echocardiographic signs of PPM are basically nonspecific with massive pericardial effusion as the most common sign, although no echocardiographic gender differences or association with in-hospital mortality could be identified.

When cardiac surgery comes to its limits: a case report of pericardial mesothelioma invading the myocardium

“…In a recently published retrospective study, myocardial infiltration was reported in no <45% of all patients undergoing cardiac surgery for PPM. 9 We therefore suggest that myocardial infiltration by PPM, and thus potential limitations to cardiac surgery, should be considered even independent of imaging results, when therapeutic options are discussed. Analysis of pericardial fluid is also of limited value in most cases.…”

Primary malignant pericardial mesothelioma: a case report

“…Echocardiographic findings are also non-specific. They may show pericardial effusion, tamponade, thickening of the pericardium, or even a pericardial mass [ 3 ]. It further allows functional cardiac evaluation and the assessment of wall motion abnormalities [ 3 ].…”

“…They may show pericardial effusion, tamponade, thickening of the pericardium, or even a pericardial mass [ 3 ]. It further allows functional cardiac evaluation and the assessment of wall motion abnormalities [ 3 ]. Magnetic resonance imaging and CT may prove useful in showing the degree of constriction and the extent of the tumor to the adjacent structures [ 2 , 5 ].…”

“…Common clinical symptoms typically include heart failure, pericardial effusion, and angina pectoris [ 2 ]. Non-invasive imaging modalities are useful to aid earlier diagnosis and guide biopsies [ 3 ]. However, histopathological examination remains the gold standard for definitive diagnosis [ 4 ].…”

Cardiac Tamponade from Pericardial Mesothelioma Causing Acute Renal Insufficiency in Dog

“…Transthoracic echocardiography is the first-line diagnostic tool for pericardial tumors. However, echocardiography contains some limitations such as tissue characterization capability and restrict field of view in mediastinal and the right heart [6]. In human medicine, other noninvasive advance imaging modalities such as magnetic resonance imaging (MRI) and computed tomography (CT) have been applied to evaluate a cardiac tumor [7].…”