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Unusual Presentation of a Primary Pericardial Malignant Mesothelioma: Constrictive Pericarditis A Case Report and Review of the Literature

Rekik Bassem, Ben Jmaa Hèla, Jerbi Bassem, Tabebi Nada, Cherif Taieb, Elleuch Ahmed, Souissi Iheb, Kammoun Samir, Masmoudi Sayda and Frikha Imed

Primary malignant pericardial mesothelioma is an extremely rare tumor with high lethality. We report the case of a 30 year-old female without medical history, who was admitted in the department of cardiology for a dyspnea and chest pain due to a large pericardial effusion. A tamponade was confirmed by echocardiography, and emergent pericardial drainage was performed. Twelve months later, the patient developed a hemodynamically relevant pericardial constriction. She underwent a partial pericardectomy. The pericardium was thick and adherent. The histological examination revealed a pericardial infiltration by malignant mesothelioma. After surgery, five cycles of chemotherapy with carboplatine were beginned.

The treatment methods of primary pericardial mesothelioma are limited. Chemotherapy in addition to surgery seems to improve symptoms in case of constriction and non-response to pericardectomy.