Pericardial
Pericardial mesothelioma is a rare form of cancer often caused by asbestos exposure. Pericardial mesothelioma refers to cancer of the thin sac that surrounds the heart and the great blood vessels (called the “pericardium”). Pericardial mesothelioma is the rarest form of mesothelioma, occurring less than 5% of mesothelioma cases.
Symptoms
Symptoms of pericardial mesothelioma are typically non-specific and can resemble symptoms of several other cardiac conditions. Symptoms may include shortness of breath, irregular heartbeat, heart palpitations and chest pain. Please keep in mind that these symptoms may be cuased by mesothelioma or by other less serious conditions. Only a doctor or preferrably a mesothelioma specialist can make a definitive diagnosis.
Diagnosis
Diagnosis of pericardial mesothelioma can be difficult as symptoms of the disease are is relatively non-specific. The process of diagnosis typically begins when doctor or, preferably a mesothelioma specialist reviews the patients medical history, including the possibility of exposure to asbestos. In order to confirm the diagnosis a tissue sample must be removed (called a biopsy) from the affected area. The biopsy involves removal of fluid (aspirate) or tissue (a biopsy) from the pericardial area, and testing of this tissue or fluid for the presence of cancer cells. This can be accomplished via a thoracoscopy or a mediastinoscopy. Chest x-rays, a CT scan or an MRI scan may also used to help diagnose pericardial mesothelioma.
Thoracoscopy
In this procedure, a small incision is made in the chest and a thoracoscope, which is an instrument similar to a telescope and is connected to a video camera, is inserted in the area of the tumor. A doctor can then view the tumor and/or take a tissue sample at this time.
Mediastinoscopy
In a mediastinoscopy, a small incision is made just above the sternum and a lighted tube is placed behind the breast bone. allowing the doctor to view the lymph nodes which can provide clues about the body’s immune system, a tissue sample may be removed at this time. Once removed, the tissue samples are then analyzed under a microscope.
X-Ray
X-ray machines use radiation to take a picture of the affected area. An x-ray may reveal several types of abnormalities including buildup of fluid in the pericardium . These abnormalities may indicate asbestos exposure and the development of mesothelioma.
CT Scan (Computed Tomography)
Type of x-ray procedure that produces detailed cross-sectional images of the body. Unlike a traditional x-ray that takes a single picture, a CT scanner takes many pictures as it rotates around you. A computer then combines these images to create a cross-sectional “slice” of the body. A radiocontrast agent or “dye” may be injected into patient intravenously, which helps define the structures of the body and may help in determining the extent to which the cancer has spread.
MRI Scan (Magnetic Resonance Imaging)
This scan uses radio waves, strong mangnets and a computer to produce a cross-sectional image of the body. The energy from the radio waves and magnets are absorbed and released by the different tissues in the body. In this procedure the patient may be injected with a radiocontrast agent prior to being positioned in the tunnel of the MRI machine.
PET Scan (Positron Emission Tomography)
This scan uses radioactive glucose (sugar) to determine the spread of cancer. Cancer tissue consumes glucose at a much faster rate than normal tissue. When radioactive glucose is injected intervenously into the patient the diseased tissue takes up higher levels of the radioactive material and when scanned, can provide insight into the stage and spread of the cancer.
Treatment
In most cases, by the time a positive pericardial diagnosis is made, the cancer has progressed to a stage where conventional treatments are largely ineffective. Palliative treatments, or treatments whose intention is to provide temporary relief from symptoms are most often employed as treatment for pericardial mesothelioma. However, in cases where the disease has been diagnosed early enough, several surgical procedures may be effective.
Source: Connelly & Vogelzang
