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Vol 72, No 5-6 (2004)
Case report
Submitted: 2013-02-22
Published online: 2008-02-18
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Diagnostic difficulties in primary mesothelioma

Leila Youssef Khalil, Monika Szturmowicz, Liliana Wawrzyńska, Anna Fijałkowska, Włodzimierz Kupis, Krystyna Maszkowska-Kopij, Ewa Szczepulska, Barbara Burakowska, Witold Tomkowski, Adam Torbicki
Pneumonol Alergol Pol 2004;72(5-6):221-225.

open access

Vol 72, No 5-6 (2004)
CASE REPORTS
Submitted: 2013-02-22
Published online: 2008-02-18

Abstract

A 54-year-old woman with a history of fatigue and shortness of breath was found to have a pericardial effusion and mild mediastinal lymphadenopathy. Video-assisted pericardioscopy revealed thickened pericardium studded with multiple nodules. Histologically the tumor was diagnosed as papillary adenocarcinoma. The site of the primary tumor could not be identified. As lung cancer is one of the most frequent causes of pericardial metastases the patient was treated with cisplatin and vinblastin. Following 5 courses of chemotherapy -given over a 4 month period- the amount of pericardial effusion and pericardial thickness did not change. The material from pericardial biopsy was reexamined and positive immunostaining for calretinine was found. The final diagnosis was primary pericardial mesothelioma of epithelioid type. Palliative radiotherapy of mediastinum was planned but the patient deteriorated and died due to disease progression with venous thrombosis and superior vena cava syndrome. The case illustrates the difficulties in establishing diagnosis of primary pericardial mesothelioma which is a rare tumor with poor prognosis.

Abstract

A 54-year-old woman with a history of fatigue and shortness of breath was found to have a pericardial effusion and mild mediastinal lymphadenopathy. Video-assisted pericardioscopy revealed thickened pericardium studded with multiple nodules. Histologically the tumor was diagnosed as papillary adenocarcinoma. The site of the primary tumor could not be identified. As lung cancer is one of the most frequent causes of pericardial metastases the patient was treated with cisplatin and vinblastin. Following 5 courses of chemotherapy -given over a 4 month period- the amount of pericardial effusion and pericardial thickness did not change. The material from pericardial biopsy was reexamined and positive immunostaining for calretinine was found. The final diagnosis was primary pericardial mesothelioma of epithelioid type. Palliative radiotherapy of mediastinum was planned but the patient deteriorated and died due to disease progression with venous thrombosis and superior vena cava syndrome. The case illustrates the difficulties in establishing diagnosis of primary pericardial mesothelioma which is a rare tumor with poor prognosis.

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Keywords

pericardial effusion; mesothelioma; cardiac tamponade

About this article
Title

Diagnostic difficulties in primary mesothelioma

Journal

Advances in Respiratory Medicine

Issue

Vol 72, No 5-6 (2004)

Article type

Case report

Pages

221-225

Published online

2008-02-18

Bibliographic record

Pneumonol Alergol Pol 2004;72(5-6):221-225.

Keywords

pericardial effusion
mesothelioma
cardiac tamponade

Authors

Leila Youssef Khalil
Monika Szturmowicz
Liliana Wawrzyńska
Anna Fijałkowska
Włodzimierz Kupis
Krystyna Maszkowska-Kopij
Ewa Szczepulska
Barbara Burakowska
Witold Tomkowski
Adam Torbicki

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