[Primary mesothelioma of the pericardium: a clinical case].
We describe a 33-years-old male patient, presenting with progressive right heart failure. After evaluation, the hypothesis of effusive-constrictive pericarditis was considered. Medical therapy was initiated with no clinical benefit. On the 15th day after admission he was proposed for surgical intervention. The intraoperatory examination revealed a thick pericardium adhering to the epicardium without a clear separation between them. Complete resection was technically impossible. The postoperative course evolved with worsening heart failure and development of renal failure requiring hemodialysis. A diagnosis of primary pericardial mesothelioma was made after histological evaluation. The patient died 8 days after surgery despite all efforts at hemodynamic compensation. Despite its rarity, this diagnosis should be considered in cases with rapid evolution of constrictive or effusive-constrictive pericarditis. The prognosis for pericardial mesothelioma is poor due to its late diagnosis, the difficulty of surgical excision and poor response to radio- or chemotherapy.
Anão
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Serviços de Cardiologia, Cirurgia Cardio-Torácica e Anatomia Patológica, Hospital de Santa Cruz, Carnaxide.
Gil
V
V
Trabulo
M
M
Ribeiras
R
R
Ferreira
M M
MM
Nogueira
M
M
Seabra-Gomes
R
R
D000328:Adult; D006338:Heart Neoplasms / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000175:diagnosis*; D010496:Pericardium