Comprehensive Treatment of a Rare Primary Malignant Pericardial Mesothelioma: A Case Report and Literature Review


Chunyu Liu, Bin Zhao, Weiwei Cheng, Dongliang Ma, Xing Wei and Shunye Zhang*

Background: Primary Malignant Pericardial Mesothelioma (PMPM) is an extremely rare aggressive malignancy with nonspecific symptoms; thus, cases of PMPM are usually found incidentally. Despite treatment, it is considered as extremely fatal.

Case presentation: We encountered an asymptomatic 64-year-old woman diagnosed with PMPM by Positron Emission Tomography/Computed Tomography (PET/CT). After 22 months of supportive treatment and chemotherapy, she presented to our facility with progressive dyspnoea. Surgery was performed. Excision biopsy showed thickening pericardium and many poorly circumscribed masses, and cut sections showed friable grey–white tissue with areas of necrosis. Pathological examination confirmed epithelium-like malignant mesothelioma. The patient was continuously treated with a previously prescribed chemotherapy regimen. The patient did not exhibit dyspnoea recurrence, and PET/CT showed no progression 7 months postoperatively.

Conclusion: Comprehensive treatment, including chemotherapy, supportive treatment, and timely surgery, is effective for unresectable PMPM. When patients present with symptoms caused by PMPM that are not relieved by medication, we recommend prioritising urgent surgery.