2014 Volume 28 Issue 7 Pages 842-847
We present the clinical and pathologic features of primary malignant pericardial mesothelioma. To better understand the clinical, radiographic, and pathologic features of this entity, we reviewed 13 cases with data stored at national Rousai Hospitals from 2004 through August 2013. Findings of the review included a Male: Female ratio of 1 : 1, an age range of 47 to 85 years old (mean, 69), and documented asbestos exposure in 9 patients (70%). Symptoms are often unspecific. Commonly used imaging studies do not show marked sensitivity: diffuse thickness of pericardium detected in 11 cases, and a pericardial mass in 2 cases by computed tomography. A diagnosis was provided by biopsy 8 cases, and post-operatively 1 case. Cytological examination of pericardial fluid is seldom conclusive (malignant cells demonstrated in 4 cases). Pathologic findings revealed a diffuse growth pattern in 10 cases, together with epithelioid findings in 46%. Chemotherapy was performed in 4 cases, and resection and chemotherapy in 1 case. Regarding the prognosis, the median survival of 13 cases was 6.0 months. To assess the prognosis, we compared the group receiving treatments with that receiving no treatments; the latter shows a prognosis as poor as the former group. In conclusion, with or without therapy, the prognosis was uniformly poor, since 12 of the patients died of the disease.