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Primary Malignant Pericardial Mesothelioma Presenting as Acute Pericarditis

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We report on a 21-year-old man with fever, dyspnea, and pleuritic chest pain. An electrocardiography showed ST elevation in multiple lead and thoracic echocardiography revealed moderate pericardial effusion. He was initially diagnosed with acute pericarditis,and treated with nonsteroidal anti-inflammatory drugs and colchicines with clinical and laboratory improvement. After 1 month of medication, his symptoms recurred. An echocardiography showed constrictive physiology and the patient was treated with steroid on the top of current medication. The patient had been well for 7 months until dyspnea and edema developed, when an echocardiography showed marked increased pericardial thickness and constriction. Pericardial biopsy was performed and primary malignant pericardial mesothelioma was diagnosed. Malignancy should be considered in the differential diagnosis of recurrent pericarditis.

Abstract

We report on a 21-year-old man with fever, dyspnea, and pleuritic chest pain. An electrocardiography showed ST elevation in multiple lead and thoracic echocardiography revealed moderate pericardial effusion. He was initially diagnosed with acute pericarditis,and treated with nonsteroidal anti-inflammatory drugs and colchicines with clinical and laboratory improvement. After 1 month of medication, his symptoms recurred. An echocardiography showed constrictive physiology and the patient was treated with steroid on the top of current medication. The patient had been well for 7 months until dyspnea and edema developed, when an echocardiography showed marked increased pericardial thickness and constriction. Pericardial biopsy was performed and primary malignant pericardial mesothelioma was diagnosed. Malignancy should be considered in the differential diagnosis of recurrent pericarditis.

참고문헌 (6)

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  2. Thomason R, "Primary malignant mesothelioma of the pericardium. Case report and literature review", Tex Heart Inst J, 21, pp.170~174 (1994)
  3. Khandaker MH, "Pericardial disease: diagnosis and management", Mayo Clin Proc, 85, pp.572~593 (2010)
  4. Göossinger HD, "Magnetic resonance imaging findings in a patient with pericardial mesothelioma", Am Heart J, 115, pp.1321~1322 (1988)
  5. Kaminaga T, "Role of magnetic resonance imaging for evaluation of tumors in the cardiac region", Eur Radiol, 13(6), pp.1~10 (2003)
  6. Papi M, "Malignant pericardial mesothelioma. Report of two cases, review of the literature and differential diagnosis", Tumori, 91, pp.276~279 (2005)

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