Fatal hemopericardial tamponade due to primary pericardial mesothelioma: A case report

Daniel C. Lingamfelter, Dominick Cavuoti, Amy C. Gruszecki

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background. Primary mesothelioma of the pericardium comprises less than 1% of all mesothelioma cases. Its typical presentation is insidious, with nonspecific signs and symptoms, and usually results in heart failure due to cardiac tamponade, either by a serous effusion or by direct tumorous constriction of the heart. With the exception of several case reports, the outcome is uniformly fatal, and patients typically die within six months of diagnosis. Case presentation. A 45-year-old African American female presented to the emergency department with several days of dizziness, difficulty walking, and low blood pressure. The patient suddenly suffered cardiac arrest, and her death was pronounced. The medical examiner assumed jurisdiction of the case due to the sudden death nature of the case without known medical history. At autopsy, a one-liter hemopericardium was present, and the pericardial sac was thick, granular and adhesed to the heart, suspicious for pericarditis. Microscopic examination of the pericardial tissue instead led to a diagnosis of primary pericardial mesothelioma. Conclusion. Our case demonstrates a pericardial mesothelioma initially masquerading grossly as pericarditis. Microscopic examination of any grossly abnormal pericardial tissue therefore may be warranted so that a neoplastic disease process does not go undetected. Additionally, of the approximately 200 such tumors reported in the medical literature, a case demonstrating marked hemopericardium and resulting in sudden death has not been described until now.

Original languageEnglish (US)
Article number44
JournalDiagnostic Pathology
Volume4
Issue number1
DOIs
StatePublished - 2009

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Mesothelioma
Pericarditis
Pericardial Effusion
Pericardium
Sudden Death
Mobility Limitation
Neoplastic Processes
Coroners and Medical Examiners
Cardiac Tamponade
Dizziness
Heart Arrest
Constriction
African Americans
Hypotension
Signs and Symptoms
Hospital Emergency Service
Autopsy
Heart Failure
Neoplasms

ASJC Scopus subject areas

  • Histology
  • Pathology and Forensic Medicine

Cite this

Fatal hemopericardial tamponade due to primary pericardial mesothelioma : A case report. / Lingamfelter, Daniel C.; Cavuoti, Dominick; Gruszecki, Amy C.

In: Diagnostic Pathology, Vol. 4, No. 1, 44, 2009.

Research output: Contribution to journalArticle

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