Pericardial mesothelioma causes a condition called cardiac tamponade, which is a buildup of fluid in the space between the muscular wall of the heart, known as the myocardium, and the outer sac, or pericardium. This constricts the heart, causing the stoppage of blood flow.
How is Pericardial Mesothelioma Diagnosed?
Diagnosing this type of tumor presents a challenge because the symptoms the patient experiences, such as chest pain, shortness of breath, palpitations, persistent coughing, and fatigue, are similar to what patients with other cardiac conditions experience. That’s why it is so important that the patient tell the doctor about previous asbestos exposure so that the doctor can make the appropriate diagnosis and order an echocardiogram, MRI or CT scan that will be able to detect the mass.
Echocardiography is a noninvasive method that uses ultrasound to study the structure of the heart. It is typically used for the initial evaluation. Since the echocardiogram shows images of both the muscular wall of the heart and the cardiac chambers, it can usually identify the presence of a tumor.
Both MRI and CT scan are other non-invasive techniques to get images of the heart. However, the MRI, in addition to these images, provides information about the chemical makeup of the tumor, giving the first indication of the type of tumor it might be.
In a study titled Role of magnetic resonance imaging for evaluation of tumors in the cardiac region, published December 2003 in European Radiology, researchers examined 25patients with heart tumors arising from different causes using MRI and echocardiography. They observed that MRI assisted in the characterization of tissue among the different tumor types, including mesothelioma. It was also useful for detecting the tumor, identifying its shape and determining whether it had penetrated other parts of the heart structure.
In patients whose tumors had spread into the cavity between the lungs, as in the case of the mesothelioma patients who were studied, MRI was useful in determining the location of the tumor and its border. In cases in which the tumors were adjacent to pericardium, MRI was useful in identifying pericardial invasion.
What is the Prognosis for Patients with Pericardial Mesothelioma?
Surgical removal of the tumor is usually the first line of treatment in pleural mesothelioma, but it is generally not recommended for pericardial mesothelioma. If it is performed, it is used to relieve the fluid buildup between the two layers of heart wall.
There is no cure for pericardial mesothelioma, so whatever treatment is recommended is palliative, meaning intended to alleviate symptoms. Radiation and chemotherapy can relieve pain, but they may also affect the quality of life.
In a study titled Primary pericardial mesothelioma presenting as pericardial constriction: a case report, published January 2004 in Heart, researchers evaluated treatment options for pericardial mesothelioma:
“Pericardial mesothelioma responds poorly to radiotherapy. Cyclical combination chemotherapy with doxorubicin, vincristine, and cyclophosphamide may reduce the tumour mass. Surgical resection (removal) can be curative in localised cases. Palliative treatment includes pericardiectomy, which prevents cardiac tamponade and relieves constriction.”
They also added that survival after diagnosis was about six weeks to 15 months.