Recurrent pericardial effusion as initial manifestation of primary diffuse pericardial malignant mesothelioma

Garrido, María José Molina; Rufete, Antonia Mora; Rodríguez-Lescure, Álvaro; Pérez, José Domingo Cascón; Ardoy, Francisco; Ponce, Carmen Guillén; Mena, Alfredo Carrato

doi:10.1007/s12094-006-0042-8

Cited by 6 publications

(4 citation statements)

References 7 publications

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“…After this no extent review has been made. Our review includes 29 cases in English literature from 1993 through 2008 where the diagnosis of primary pericardial mesothelioma was established [5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29]. It also includes the findings from our patient and the review, presented in table 1 and table 2.…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

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Primary Pericardial Mesothelioma: Report of a Patient and Literature Review

Nilsson

Rasmuson

2009

Case Rep Oncol

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Primary mesothelioma of the pericardium is a rare tumor and carries a dismal prognosis. This case report presents a 38-year-old man who suffered from recurrent pericardial fluid. Initial symptoms were unspecific, with dry cough and progressing fatigue. Pericardiocentesis was performed, but analyses for malignant cells and tuberculosis were negative. After recurrence a pericardiectomy was planned. At operation, partial resection of tumor tissue surrounding the heart was performed. Histopathologic examination including immunohistochemical staining for calretinin showed a biphasic mesothelioma. During the postoperative period the patient’s condition ameliorated, but symptoms recurred and the patient died 3 months after diagnosis and 15 months after the first symptoms. At autopsy, the pericardium was transformed by the tumor that also expanded into the mediastinum and had set metastases to the liver. A review of 29 cases presented in the recent literature indicates a higher incidence of malignant pericardial mesothelioma among men than women. Median age was 46 (range, 19–76) years. In pleural mesotheliomas, exposure to asbestos is a known risk factor. However, in primary pericardial mesotheliomas the evidence for asbestos as an etiologic factor seems to be less convincing (3 exposed among 14 cases). Symptoms are often unspecific and cytologic examination of pericardial fluid is seldom conclusive (malignant cells demonstrated in 4/17 cases). Partial resection of the tumor can give a period of symptom reduction. Only a few patients have been treated with chemotherapy. Median survival of patients with pericardial mesotheliomas is approximately 6 months.

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Section: Discussion and Literature Reviewmentioning

confidence: 99%

“…Three cases with known exposure to asbestos are reported [5,6,7]. For 11 of the patients no known exposure to asbestos is reported [8,9,10,11,12,13,14,15,16]. Most of the reviewed articles do not contain any information about asbestos exposure.…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Primary Pericardial Mesothelioma: Report of a Patient and Literature Review

Nilsson

Rasmuson

2009

Case Rep Oncol

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“…In contrast to pleural mesothelioma, the association of asbestos exposure with pericardial mesothelioma is unclear (Eren and Akar, 2002; Val-Bernal et al, 2002; Lagrotteria et al, 2005; Papi et al, 2005; Luk et al, 2008). Although a few reported cases have occurred in individuals with occupational asbestos exposure (Kahn et al, 1980; Beck et al, 1982; Thomason et al, 1994; Fujiwara et al, 2005), it appears that the vast majority of recently reported cases had no known asbestos exposure (Quinn et al, 2000; Hirano et al, 2002; Reis-Filho et al, 2002; Val-Bernal et al, 2002; Susman et al, 2004; Yakirevich et al, 2004; Erdogan et al, 2005; Lagrotteria et al, 2005; Maruyama et al, 2006; Molina Garrido et al, 2006; Doval et al, 2007; Vornicu et al, 2007; Akamoto et al, 2008; Santos et al, 2008), and many were reported in younger individuals (e.g., age 19–50 years). Malignant mesothelioma of the pleural cavity was also reported to occur in a 15-year old boy with rheumatic heart disease and a prosthetic aortic valve implant; this child was reported to have no history of asbestos or chemical exposure (Tewari et al, 1989).…”

Section: Basis For Genetic Testing Of Mesothelioma and Histologicallymentioning

confidence: 99%

“…Pericardial mesothelioma is estimated to comprise only 0.7–1% of all mesotheliomas (Papi et al, 2005; Molina Garrido et al, 2006) and lacks a specific immunohistochemical staining pattern that would distinguish this lesion from mesotheliomas originating at other sites (Reis-Filho et al, 2002; Papi et al, 2005). In contrast to pleural mesothelioma, the association of asbestos exposure with pericardial mesothelioma is unclear (Eren and Akar, 2002; Val-Bernal et al, 2002; Lagrotteria et al, 2005; Papi et al, 2005; Luk et al, 2008).…”

Section: Basis For Genetic Testing Of Mesothelioma and Histologicallymentioning

confidence: 99%

Tumors that mimic asbestos-related mesothelioma: time to consider a genetics-based tumor registry?

Kerger¹,

James

Galbraith

2014

Front. Genet.

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The diagnosis of mesothelioma is not always straightforward, despite known immunohistochemical markers and other diagnostic techniques. One reason for the difficulty is that extrapleural tumors resembling mesothelioma may have several possible etiologies, especially in cases with no meaningful history of amphibole asbestos exposure. When the diagnosis of mesothelioma is based on histologic features alone, primary mesotheliomas may resemble various primary or metastatic cancers that have directly invaded the serosal membranes. Some of these metastatic malignancies, particularly carcinomas and sarcomas of the pleura, pericardium and peritoneum, may undergo desmoplastic reaction in the pleura, thereby mimicking mesothelioma, rather than the primary tumor. Encasement of the lung by direct spread or metastasis, termed pseudomesotheliomatous spread, occurs with several other primary cancer types, including certain late-stage tumors from genetic cancer syndromes exhibiting chromosomal instability. Although immunohistochemical staining patterns differentiate most carcinomas, lymphomas, and mestastatic sarcomas from mesotheliomas, specific genetic markers in tumor or somatic tissues have been recently identified that may also distinguish these tumor types from asbestos-related mesothelioma. A registry for genetic screening of mesothelioma cases would help lead to improvements in diagnostic criteria, prognostic accuracy and treatment efficacy, as well as improved estimates of primary mesothelioma incidence and of background rates of cancers unrelated to asbestos that might be otherwise mistaken for mesothelioma. This information would also help better define the dose-response relationships for mesothelioma and asbestos exposure, as well as other risk factors for mesothelioma and other mesenchymal or advanced metastatic tumors that may be indistinguishable by histology and staining characteristics.

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