Abstract

QUINTERO, Viviana; MUNERA, Ana G.; ARROYAVE, Jorg e A.  and  DUQUE, Mauricio. Primary pericardial mesothelioma presenting as severe pericardial effusion. Rev. Colomb. Cardiol. [online]. 2015, vol.22, n.1, pp.44-48. ISSN 0120-5633.  https://doi.org/10.1016/j.rccar.2015.01.002.

Introduction and objectives: Primary pericardial mesothelioma is an extremely rare tumor with poor prognosis whose etiology remains unknown. It is expressed clinically as dyspnea and pericardial effusion. The case of a young patient who presented with severe pericardial effusion as the initial manifestation of pericardial mesothelioma is described. Case report: 34 year-old man with 3-month symptoms of consistent in limb edema, dyspnea and increased abdominal girth. Transthoracic echocardiography documented severe pericardial effusion; 2,660 ml of citrine liquid was obtained by pericardiocentesis. Cardiac magnetic resonance imaging evidenced thickening, nodularity of the pericardium and signs of fibrosis. Pericardial biopsy was diagnostic of malignant mesothelioma. Systemic chemotherapy was initiated by oncology. Discussion: Pericardial mesothelioma accounts for less than 3% of cardiac tumors and pericardium. Associated risk factors are unknown, occurring more often in men. The diagnosis is usually delayed with metastases present in more than 50% of patients. There is no standard therapy and it is usually only palliative. The prognosis is poor, with a median survival of only 6 months. Conclusions: Severe and recurrent pericardial effusion may be the first manifestation of primary pericardial mesothelioma and should be considered as a differential diagnosis in this clinical presentation.

Keywords : Pericardium; Tumor; Heart failure.

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