| Pericardial mesothelioma accounts for about half of all | | | | H) Fever or night sweats |
| pericardial tumors and is extremely rare. This cancer | | | | I) Orthopnoea (breathlessness on lying down) |
| accounts for about 6% of all mesothelioma cases, | | | | These symptoms are not specific for the cancer, |
| these tumors are typically diffused and tend to cover | | | | making the clinical diagnosis very difficult. |
| the whole heart. | | | | Diagnosis |
| Pericardial mesothelioma affects the pericardium which | | | | After getting a clinical diagnosis a series of tests can |
| is the membrane made up of mesothelial cells that | | | | be done to locate the cancer and identify the cancer |
| surrounds and protects the heart. This membrane has | | | | cells. |
| two layers: | | | | -MRI, Magnetic Resonance Imaging |
| A} an outer layer called parietal pericardium | | | | This is useful in assessing and determining the extent |
| B} an inner layer called the visceral pericardium | | | | of development of the cancer. |
| {epicardium} | | | | -Biopsy |
| Cause | | | | This involves the removal of pericardium tissue or fluid |
| Unlike in the case of pleural mesothelioma, there is no | | | | for laboratory test to confirm the presence of |
| clear link between this cancer and exposure to | | | | mesothelioma cells. |
| asbestos fibers, but a number of patients with | | | | -Chest x-ray |
| pericardial mesothelioma have a history of exposure | | | | This helps to identify the tumor, there is a characteristic |
| to asbestos. | | | | shape of the heart on the x-ray film when there is a |
| Some schools of thought believe that it is the inhaled | | | | tumor of the pericardium. |
| asbestos fibers in the lungs that travel via blood from | | | | -Chest CT scan |
| the lungs to the heart, although this theory is not | | | | This also helps to identify the tumor. |
| supported by conclusive evidence. | | | | Treatment |
| When asbestos fibers get lodged in the pericardium, | | | | Pericardial mesothelioma patients are not usually |
| the body is unable to excrete the asbestos fibers and | | | | suitable for surgery, except in rare cases where the |
| they remain stuck in the pericardium. These fibers over | | | | cancer is diagnosed very early and surgery may be |
| a long period of time cause the pericardial cells to | | | | done to remove small localized tumors. |
| undergo changes that result into cancerous | | | | This type of surgery is very risky because of the |
| transformation. | | | | proximity of the heart. |
| The cancer cells divide without control and they | | | | Palliative treatment is often the only option for treating |
| eventually lead to the thickening of the pericardial | | | | pericardial mesothelioma, this type of treatment is |
| membranes eventually causing development of the | | | | aimed at improving the patient's quality of life and |
| tumors. These changes lead to the accumulation of | | | | reducing the severity of symptoms caused by the |
| fluids in between the two layers which combined with | | | | accumulation of fluid in the pericardium. |
| the thickening of these layers result in the compression | | | | Fine needle aspiration may be done to drain the |
| of the heart. | | | | accumulated fluid surrounding the heart. Radiotherapy |
| Symptoms | | | | could also be used to shrink the tumor to alleviate the |
| Most of the symptoms are caused by the | | | | symptoms caused by the compression of the heart |
| accumulation of fluids and the thickening of the | | | | by the accumulating fluid. The proximity of the heart |
| pericardial layer. The common symptoms are: | | | | and lungs however makes this a very risky procedure. |
| A) Heart palpitations or irregular pulse (arrhythmias) | | | | Prognosis |
| B) Chest pain | | | | The prognosis of this type of mesothelioma is very |
| C) Murmurs (abnormal heart sounds) | | | | poor, about 50 -60% of all cases die within 6 months |
| D) Cough | | | | of diagnosis. Occasionally few patients survive for |
| E) Dyspnoea (shortness of breath) | | | | longer periods following treatment with partial surgical |
| F) Fatigue | | | | resection and radiotherapy. |