Post-Irradiation Malignant Pericardial Mesothelioma with Recurrent Bloody Pericardial Effusion:a Case Report

Shuntaro Ito＊	Kenji Mogi＊	Manabu Sakurai＊
Kengo Tani＊	Masafumi Hashimoto＊	Yoshiharu Takahara＊

（Division of Cardiovascular Surgery, Funabashi Municipal Medical Center Heart and Vascular Institute＊, Funabashi, Japan）

We report a case of a 64-year-old woman with a history of radiation therapy for breast cancer 27 years ago who developed malignant pericardial mesothelioma. Since 3 years ago, the recurrent bloody pericardial effusion was getting worse, which caused general edema and nocturnal dyspnea. She had a thickened pericardium and the right ventricular pressure curve showed a dip-and-plateau pattern. We diagnosed constrictive pericarditis and performed a pericardiectomy and waffle procedure on the thickened epicardium without cardiopulmonary bypass. The post-operative histology confirmed malignant pericardial mesothelioma and she died on the 17th postoperative day. Pericardial malignant mesothelioma is a rare disorder but very aggressive. This fatal disease may be considered in a patient with recurrent bloody pericardial effusion who has a history of thoracic radiation therapy.

 

Jpn. J. Cardiovasc. Surg. 50:34-37（2021）

Keywords：malignant pericardial mesothelioma;post-irradiation;constrictive pericarditis