Pericardial Mesothelioma

Pericardial mesothelioma is the least common of mesotheliomas linked to asbestos exposure.  Unlike pleural and peritoneal mesotheliomas which affect the lungs and abdomen respectively, pericardial mesothelioma impacts the heart.  Specifically, the malignancy occurs in the pericardium, the protective, mesothelial layer that surrounds the heart.  Accounting for 1-2% of all mesothelioma cases, fewer than 50 people are diagnosed with pericardial mesothelioma each year.  Due in part to the location of the tumor, prognosis for pericardial mesothelioma is the poorest of the malignant mesotheliomas.  Tragically, only half of those diagnosed with pericardial mesothelioma live longer than 6 months.  

Since pericardial mesothelioma is very rare, there have been fewer opportunities to research the condition. Although linked to asbestos exposure, less is known about how the asbestos fibers reach the pericardium.  Typically, exposure to asbestos involves the inhalation or swallowing of asbestos fibers.

Since symptoms of pericardial mesothelioma are similar to more common heart conditions, misdiagnosis or delayed diagnosis may occur.   Unfortunately, many cases of pericardial mesothelioma are not discovered until an autopsy is performed.  Symptoms of pericardial mesothelioma include chest pain, fatigue, and shortness of breath.  The impact of pericardial mesothelioma on cardiovascular function may include the development of fluid around the heart, heart murmurs and arrhythmia.

A variety of tests may be performed in order to diagnose pericardial mesothelioma.  An echocardiogram may be performed which uses sound waves to evaluate how well the heart is working.  Additionally, a CT scan may be used to find the location of the tumor and to determine the stage of the disease. 

Due to the tumor’s proximity to the heart, the surgical removal of the tumor, a procedure called a pericardiectomy, is rarely an option unless the tumor is particularly small and the individual is considered to be healthy enough to survive the procedure.  The more commonly used treatment options include chemotherapy and radiation treatments. For more information on malignant mesotheliomas, including pericardial mesothelioma, see the American Cancer Society’s website.