Malignant Pericadrial Mesothelioma

Pericardial Mesothelioma

Malignant mesothelioma of the pericardium is a rare cancer with an incidence of just 0.0022% in an autopsy series of five million cases.  The pericardium is the tissue surrounding the heart that forms a sac and allows the heart to move easily within the confines of the chest.  The annual incidence has been estimated at only 1 in 40,000,000.   An antemortem (before death) diagnosis was made in less than 1/3 of 150 reported cases in the medical literature.  This is because pericardial mesothelioma is difficult to diagnose.  It is very rare leading doctors to think it must be something else.

Pericardial mesotheliomas can occur at any age, but people from their 30s to their 60s are most likely to get it.  There is a two to one male to female ratio.

Symptoms

Patients generally present with a pericardial effusion (fluid around the heart), congestive heart failure, an anterior mediastinal mass (a mass in the front of the chest), or tamponade.  Cardiac tamponade, also known as pericardial tamponade, is an emergency condition in which fluid accumulates in the pericardium (the sac in which the heart is enclosed).  If the fluid significantly elevates the pressure on the heart it will prevent the heart's ventricles from filling properly. T his in turn leads to a low stroke volume.  The end result is ineffective pumping of blood, shock, and often death.  For more information on pericardial symptoms see the National Cancer Institute's page on cardiopulmonary syndrome.

Diagnosis

Like all mesotheliomas, diagnosis can be difficult because of the nonspecific presentation meaning the symptoms could be caused by many things, most of which are far more common than pericardial mesothelioma.  Also, chest x-rays may show only an enlarged cardiac silhouette.  Echocardiography can reveal evidence of an effusion, thickening of the pericardium, or mass involvement of the myocardium.  The myocardium is the muscle of the heart.

Treatment

Currently surgical excision (removal) is the treatment for primary pericardial mesothelioma.  It is not curative but used to palliate (lessen or ease) symptoms of constriction or tamponade. 

Additional Information

For more information on this rare cancer search the MedLine's massive PubMed database to read medical journal articles.

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