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Vol.62 No.3 contents | Japanese/English |
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- Case Report -
An Autopsy Case of Primary Malignant Pericardial Mesothelioma -A Comprehensive Review of 95 Cases Reported in Japan-
Moe Shioya1, Yoshiya Sugiura2, Tamako Irie1, Sho Hayakawa1, Hiroki Wakabayashi1, Kotaro Iwasaki1, Hiroyuki Hiruta2, Yasuo Matsuzawa11Respiratory Medicine, 2Pathology Department, Toho University Medical Center Sakura Hospital, Japan
Background. Primary malignant pericardial mesothelioma is an extremely rare disease. We herein report an autopsy case and review cases reported in the last 20 years in Japan. Case. A 58-year-old woman with dyspnea was referred to our hospital for an abnormal chest shadow under suspicion of a mediastinal tumor. Chest computed tomography showed a giant mediastinal tumor (100×95 mm) and a small amount of pericardial effusion. The tumor was located in the base of heart and compressed the main blood vessels and main bronchi. Based on the findings of a transthoracic ultrasound-guided biopsy and imaging, we diagnosed her with primary malignant pericardial mesothelioma. She received chemotherapy (cisplatin and pemetrexed) and palliative radiotherapy at the same time but ultimately died of cardiac tamponade and tumor disseminated intravascular coagulation two months later. An autopsy revealed that the cardiac tamponade had been caused by mucinous pericardial fluid and a hematoma in the pericardial cavity. The histologic subtype was epithelial type. Conclusion. The most common symptom of primary malignant pericardial mesothelioma is heart failure with pericardial effusion. A pericardial fluid sample frequently shows negative cytology, so we should perform a pericardial biopsy for a definitive diagnosis. Chemotherapy with a platinum agent and pemetrexed is effective.
key words: Malignant pericardial mesothelioma, Mediastinal tumor, Programmed cell-death ligand 1
Received: September 28, 2021
Accepted: December 9, 2021
JJLC 62 (3): 207-215, 2022
