Sudden cardiac death due to primary malignant pericardial mesothelioma: Brief report and literature review

Martínez‐Girón, Rafael; Pantanowitz, Liron; Martínez-Torre, Santiago; Pantanowitz, Joshua

doi:10.1016/j.rmcr.2019.01.011

Cited by 7 publications

(6 citation statements)

References 41 publications

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“…La capacidad invasiva de estructuras adyacentes y de producir metástasis a distancia, también van a ser factores importantes para evaluar individualmente el pronóstico; aunque la muerte precoz suele estar definida por la restricción severa que causa, aun cuando la infiltración se limita al pericardio [2,5,9].…”

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“…EI mesotelioma es un tumor de origen mesodérmico, que suele aparecer en peritoneo o pleura y raramente lo hace en el pericardio, como mesotelioma pericárdico primario (MPP) [1], es aún el tumor primario maligno de pericardio más común [2]. Las primeras menciones del mesotelioma se remontan a los años 60, cuando se describe inicialmente como un diagnóstico de exclusión post-mortem, tras buscar de forma exhaustiva en la autopsia otro foco primario de malignidad [3].…”

Section: Introductionunclassified

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Caso Clínico: Mesotelioma primario de pericardio

et al. 2020

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BACKGROUND: Primary pericardial mesothelioma is an extremely rare mesodermal tumor, among oncological diseases, with a very low incidence. About 350 cases have been described around the world, most of them diagnosed post-mortem. The short term prognosis is poor, regardless of the treatment, which is mostly palliative. We present a case report regarding this pathology. CASE REPORT: 69 year old patient hospitalized with dyspnea and severe anemia. Complementary workup showed pleural effusion and pericardial effusion. Histopathology report of the pericardial fluid revealed pericardial mesothelioma. EVOLUTION: Due to recurrence of pericardial effusion, it was decided to perform pericardiectomy and left pleurectomy as palliative treatment, to alleviate the patient’s symptoms. Chemotherapy was planned after the procedure, but the patient’s general condition deteriorated severely leading to his death. CONCLUSION: Primary pericardial mesothelioma is a rare tumor, whose symptoms are characterized by the associated pericardial effusion, making the diagnosis difficult due to it low incidence. The prognosis is poor in short- term, and there isn’t an established protocol for the treatment with results that showed improve in mortality. KEYWORDS: MESOTHELIOMA, PERICARDIAL EFFUSION, PERICARDIECTOMY, PLEUROTOMY.

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Caso Clínico: Mesotelioma primario de pericardio

et al. 2020

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“… 4 Accordingly, many patients are diagnosed at an advanced stage of the disease or post-mortem. 5 Thereby the overall survival of patients suffering from PPM is poor, with a median survival of 3 months without surgical intervention. 6 Therapeutic options for PPM include resecting surgery, radiation, and chemotherapy with only limited data on treatment efficacy.…”

Section: Introductionmentioning

confidence: 99%

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

Pölzl

Hirsch

Mayr

et al. 2021

European Heart Journal - Case Reports

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Background Primary pericardial mesothelioma (PPM) is a rare form of highly aggressive cancer. Many patients are diagnosed only at an advanced stage. Therefore, the overall survival rate is poor with a median survival of 3 months. In some rare cases, the PPM infiltrates the myocardium causing lethal myocardial dysfunction. Case summary A 66-year-old patient was transferred to our centre with the provisional diagnose of pericarditis of unknown origin. Using extensive cardiac imaging [echocardiography, computed tomography (CT), positron emission tomography–CT, cardiac magnetic resonance imaging, left and right heart catheterization, coronary angiography], PPM was finally diagnosed. After consultation with the oncologists, the heart team decided to resect the tumour first due to impaired haemodynamics and then initiate adjuvant chemotherapy. Intraoperatively, myocardial infiltration of the tumour became apparent, which was not detected preoperatively despite intensive imaging. Complete resection of the PPM was not possible and effective decompression of the ventricle could not be achieved. The patient died on the first postoperative day. Discussion Surgical therapy is indicated in many forms of cardiac tumours. However, when a tumour invades the myocardium, surgery often comes to its limits. In this case, myocardial invasion of PPM could not be detected despite extensive imaging. We therefore suggest that possible myocardial infiltration by PPM, and thus potential limitations of cardiac surgery, should be considered independently of imaging results when therapeutic options are discussed.

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“…Malignant disease of the pericardium, either primary or metastatic, is known to be the cause of pericardiac effusion. 1,2 The major etiological factors of malignant pericardial effusion include lung cancer, breast cancer, lymphoma, and leukemia, whereas cardiac metastasis from gynecological malignancies is known to be extremely rare. As far as the authors are aware, endometrial mixed carcinoma has never been reported to cause malignant pericardial effusion.…”

Section: Introductionmentioning

confidence: 99%

Case report of large malignant pericardial effusion in a post-surgical setting of endometrial mixed carcinoma: A description of unique cytological, histological, and immunohistochemical findings

Mizuguchi

Shioya

Sasagawa

et al. 2020

SAGE Open Medical Case Reports

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Appearance of endometrial carcinoma in pericardial effusion is extremely rare. Its major etiological factors include lung cancer, breast cancer, lymphoma, and leukemia. We herein report a case of a large malignant pericardial effusion 7 years after surgery for endometrial carcinoma. A 66-year-old woman who underwent modified radical hysterectomy, bilateral salpingo-oophorectomy, and lymph node dissection for endometrial carcinoma 7 years ago and who had self-interrupted subsequent chemotherapy was presented with vertigo and vomiting. Chest computed tomography revealed pericardial effusion. Cytological examination diagnosed it as adenocarcinoma with psammoma bodies and mitoses. Immunohistochemistry analysis revealed that adenocarcinoma cells were positive for p53, p16, and insulin-like growth factor II mRNA-binding protein-3, but negative for estrogen receptor. Adenocarcinoma cells in pericardial effusion were morphologically and immunohistochemically similar to the serous carcinoma component of the surgical specimen. The appearance of psammoma bodies in cytological examination triggered the diagnosis.

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Sudden cardiac death due to primary malignant pericardial mesothelioma: Brief report and literature review

Cited by 7 publications

References 41 publications

Caso Clínico: Mesotelioma primario de pericardio

Caso Clínico: Mesotelioma primario de pericardio

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

Case report of large malignant pericardial effusion in a post-surgical setting of endometrial mixed carcinoma: A description of unique cytological, histological, and immunohistochemical findings

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