Pericardial Mesothelioma

Pericardial mesothelioma is much less common than malignant mesothelioma of the pleura or peritoneum.

Pericardial mesothelioma is a specific form of mesothelioma that affects the pericardium. The pericardium is a double-walled sac that contains the heart and the roots of the great vessels.

Pericardial mesothelioma is extremely rare, although it is the most common primary malignant pericardial tumor. Its incidence was < 0.0022% among 500 000 cases in a large necropsy study[1]. Approximately 200 cases have been reported to date and only 25% of these were antemortem diagnoses[2].

Pericardial mesothelioma can present as a localised or as a diffuse mass. Three histological types have been described: epithelial, spindle cell, and mixed[3].

Likes all mesotheliomas, pericardial mesothelioma is a result of asbestos fibers that enter the body and become embedded in the mesothelium. While it is not completely understood how the asbestos fibers reach the heart, it is hypothesized that the asbestos fibers enter the bloodstream through the lungs where they are then pumped to the heart; eventually becoming lodged in the pericardium.

The prognosis for pericardial mesothelioma is extremely poor due to its late presentation and difficulty in completely removing it surgically and, unfortunately, there still is not a radical therapy for this tumor.

Symptoms

The onset of pericardia mesothelioma symptoms is usually insidious. Common clinical manifestations of pericardial mesothelioma are constrictive pericarditis, pericardial effusion, cardiac tamponade, and heart failure caused by myocardial infiltration.

Further symptoms may arise due to compression of coronary arteries and local spread into the surrounding great vessels. Primary mesothelioma can also mimic tuberculous pericarditis or intra-atrial myxomas. Distant metastasis, conduction block due to myocardial infiltration,[4] and tumor embolism causing neurological deficits[5] have also been reported.

Diagnosis

As with all mesotheliomas, an accurate diagnosis of pericardial mesothelioma can be challenging. Normally a tissue biopsy is necessary to yield a definitive diagnosis.

Staging

There is currently no established staging system for pericardial mesothelioma, however staging can be done using the TNM system. This system refers to the status of the tumor (T), lymph nodes (N) and metastases (M).

Staging helps researchers and health care providers exchange information about patients. It also gives them a common language for evaluating the results of clinical trials and comparing the results of different trials.

Treament

Mesothelioma treatment is either designed to treat the immediate area of the primary mesothelioma growth or the whole body. Whole body treatments are called systemic treatments. Localised treatments include surgery and radiotherapy. Systemic treatments act on cancer cells no matter where they may be in the body and include chemotherapy.

Treatment options for peritoneal mesothleioma depend on a number of factors, including:

  • the stage of mesothelioma
  • pre-existing medical conditions
  • patient’s general fitness

Unfortunately, mesothelioma does not always respond to cancer treatments. Doctors and researchers are working to improve mesothelioma treatment all the time. You may be offered treatment as part of a clinical trial and not as a standard treatment. The results of the trials will be used to improve treatment in the future. There is information about taking part in clinical trials.

Legal Options

If you or a loved one have been diagnosed with mesothelioma, or if you are experiencing the symptoms associated with mesothelioma, you may have a claim against the manufacturers of these asbestos products.

Please contact us today by filling out the brief questionnaire, or by calling our toll free number (1-800-898-2034) for a free, no-cost, no-obligation legal evaluation of your case.

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