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Primary pericardial mesothelioma: A cancer without prognosis? An epidemiological and clinical challenge
1
Students’ Scientific Club, Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
2
Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice,
Corresponding author
Estera Pazek
Studenckie Koło Naukowe, Katedra i Klinika Kardiochirurgii, Transplantologii, Chirurgii Naczyniowej i Endowaskularnej, Śląskie Centrum Chorób Serca, ul. M. Curie-Skłodowskiej 9, 41-800 Zabrze
Studenckie Koło Naukowe, Katedra i Klinika Kardiochirurgii, Transplantologii, Chirurgii Naczyniowej i Endowaskularnej, Śląskie Centrum Chorób Serca, ul. M. Curie-Skłodowskiej 9, 41-800 Zabrze
Ann. Acad. Med. Siles. 2025;1(nr specj.):59-65
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Primary pericardial mesothelioma (PPM) is an exceptionally rare and aggressive malignancy, identified in less than 0.0022% of all autopsy examinations. Due to its nonspecific clinical course and symptom overlap with more common cardiopulmonary conditions, diagnosis is typically delayed and made at an advanced stage, significantly worsening prognosis. The median overall survival ranges from 6 to 10 months.
Material and Methods:
A literature review was conducted using the PubMed, Medline, and Web of Science databases, covering PPM cases published between January 2015 and March 2025. The search was performed using the keywords “primary pericardial mesothelioma,” “pericardial mesothelioma,” and “malignant pericardial mesothelioma.” The collected data included clinical presentation, diagnostic methods, treatment approaches, and patient survival outcomes.
Results:
The clinical manifestations of PPM are nonspecific and commonly include pericardial effusion, chest pain, and symptoms of heart failure. Histopathological examination remains the diagnostic gold standard. Treatment strategies are primarily extrapolated from pleural mesothelioma protocols and involve chemotherapy (cisplatin + pemetrexed), surgery, and palliative care. Emerging therapies such as immunotherapy and anti-angiogenic agents (e.g., bevacizumab) have demonstrated potential efficacy.
Conclusions:
PPM is characterized by diagnostic challenges, high mortality, and the absence of standardized treatment guidelines. Early diagnosis and a multimodal therapeutic approach may contribute to improved outcomes. Further prospective, multicenter studies are needed to develop effective treatment strategies for this rare malignancy.
Primary pericardial mesothelioma (PPM) is an exceptionally rare and aggressive malignancy, identified in less than 0.0022% of all autopsy examinations. Due to its nonspecific clinical course and symptom overlap with more common cardiopulmonary conditions, diagnosis is typically delayed and made at an advanced stage, significantly worsening prognosis. The median overall survival ranges from 6 to 10 months.
Material and Methods:
A literature review was conducted using the PubMed, Medline, and Web of Science databases, covering PPM cases published between January 2015 and March 2025. The search was performed using the keywords “primary pericardial mesothelioma,” “pericardial mesothelioma,” and “malignant pericardial mesothelioma.” The collected data included clinical presentation, diagnostic methods, treatment approaches, and patient survival outcomes.
Results:
The clinical manifestations of PPM are nonspecific and commonly include pericardial effusion, chest pain, and symptoms of heart failure. Histopathological examination remains the diagnostic gold standard. Treatment strategies are primarily extrapolated from pleural mesothelioma protocols and involve chemotherapy (cisplatin + pemetrexed), surgery, and palliative care. Emerging therapies such as immunotherapy and anti-angiogenic agents (e.g., bevacizumab) have demonstrated potential efficacy.
Conclusions:
PPM is characterized by diagnostic challenges, high mortality, and the absence of standardized treatment guidelines. Early diagnosis and a multimodal therapeutic approach may contribute to improved outcomes. Further prospective, multicenter studies are needed to develop effective treatment strategies for this rare malignancy.
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