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Review
. 2012;39(2):261-4.

Primary pericardial mesothelioma unique case and literature review

Muhammad Rizwan Sardar  1 , Catherine Kuntz, Toralben Patel, Wajeeha Saeed, Eric Gnall, Shotaro Imaizumi, Leah Lande
Affiliations
Review

Primary pericardial mesothelioma unique case and literature review

Muhammad Rizwan Sardar et al. Tex Heart Inst J. 2012.

Abstract

A 72-year-old woman, on warfarin therapy and with a remote history of breast cancer and radiation treatment, presented with a 10-day history of nausea, dyspnea, dry cough, and dizziness. An electrocardiogram showed new-onset atrial fibrillation. Computed tomography of the chest revealed multiple pulmonary emboli and a pericardial effusion. Echocardiography showed a pericardial effusion with tamponade characteristics. The patient's condition deteriorated, and a pericardiectomy was performed. Histologic evaluation confirmed primary pericardial mesothelioma. She underwent palliative treatment and died 3 months after discharge from the hospital. We discuss the patient's case and the nature of primary pericardial mesothelioma, a rare oncologic entity.

Keywords: Cardiac tamponade/etiology; fatal outcome; heart neoplasms/complications/diagnosis/pathology/ultrasonography; mesothelioma/complications/diagnosis/pathology; pericardial effusion/etiology; pericardiectomy; pulmonary embolism/pathology.

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Figures

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Fig. 1 Baseline chest radiograph shows a globular heart, suggesting pericardial effusion.
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Fig. 2 Chest computed tomography shows A) bilateral pulmonary emboli and B) a large pleural and pericardial effusion.
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Fig. 3 Transthoracic echocardiograms. A) Parasternal long-axis view shows a large pericardial effusion (arrows). B) Pulsed-wave Doppler interrogation (apical 4-chamber view) yields >25% variation in E-wave velocity across the mitral valve with respiration, suggesting pericardial tamponade.
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Fig. 4 Photomicrographs show A) poorly differentiated neoplastic cells (H & E, orig. ×200) and B) positive calretinin staining (immunohistochemistry stain, orig. ×200).
See this image and copyright information in PMC

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