Primary Malignant Pericardial Mesothelioma Presenting as Acute Pericarditis

Abstract

We report on a 21-year-old man with fever, dyspnea, and pleuritic chest pain. An electrocardiography showed ST elevation in multiple lead and thoracic echocardiography revealed moderate pericardial effusion. He was initially diagnosed with acute pericarditis, and treated with nonsteroidal anti-inflammatory drugs and colchicines with clinical and laboratory improvement. After 1 month of medication, his symptoms recurred. An echocardiography showed constrictive physiology and the patient was treated with steroid on the top of current medication. The patient had been well for 7 months until dyspnea and edema developed, when an echocardiography showed marked increased pericardial thickness and constriction. Pericardial biopsy was performed and primary malignant pericardial mesothelioma was diagnosed. Malignancy should be considered in the differential diagnosis of recurrent pericarditis.

Positive response of a primary malignant pericardial mesothelioma to pemetrexed plus cisplatin followed by pemetrexed maintenance chemotherapy: A case report

“…Compared with other cases, the time interval between the previous pericardial effusion and the current presentation were too long for a diagnosis of recurrent pericardial effusion in the present case, making it difficult to connect with PMPM. However, PMPM should be considered as a cause of unexplained recurrent pericardial effusion, considering previous cases (6,7,21,22).…”

“…The disease presents with non-specific symptoms, including dyspnea or chest pain (4,5). Initial manifestations, including pericardial effusion or pericardial thickening, frequently result in confusion with pericarditis or heart failure and delay diagnosis (4,6,7). Therefore, multi-modal imaging methods, including echocardiography, computed tomography (CT), magnetic resonance imaging (MRI) and 18 F-fluorodeoxyglucose-positron emission tomography, are often required for the diagnosis (8,9).…”