What Causes Pericardial Mesothelioma?

The exact causes of pericardial mesothelioma are unknown, although doctors and specialists usually attribute it to the inhalation or ingestion of asbestos fibers. The microscopic fibers end up lodged in the pericardium, where they cause irritation and inflammation. This, in turn, creates scar tissue, which later develops into cancerous tumors. Eventually, symptoms become so painful the individual seeks treatment.

However, pericardial mesothelioma cannot always be linked to asbestos exposure, as other factors play a role. Patients with a genetic predisposition to the disease, an impaired immune system, radiation exposure, or systemic inflammation in the body can increase the risk of this form of mesothelioma.

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What Are the Symptoms?

Symptoms of pericardial mesothelioma vary but are often similar to those of other heart conditions, including heart disease or cardiac inflammation. The main symptoms of this disease include:

  • Arrhythmia
  • Chest pain
  • Shortness of breath
  • Fatigue
  • Heart murmur
  • Weight loss

In addition to the above symptoms, some patients may experience a condition called pericardial effusion — a buildup of fluid surrounding the heart — which can cause chest pain and make breathing more difficult. Commonly, effusions require treatment in the form of outpatient surgery.

How Is Pericardial Mesothelioma Diagnosed?

Because symptoms are similar to other forms of heart disease, diagnosing a case of pericardial mesothelioma can be quite difficult. Doctors use a combination of imaging tests, blood tests, and biopsies. Patients may also undergo two additional tests that are specifically designed for this form: pericardiocentesis, pericardial biopsy (a biopsy done with a needle), and an echocardiogram, which utilizes ultrasound waves to produce a visual image of heart function.

Staging Pericardial Mesothelioma

The two other types of mesothelioma, pleural and peritoneal, are more common and therefore easier to diagnose, especially if the patient knows they were directly or indirectly exposed to asbestos. Patients with malignant pleural and peritoneal mesothelioma sometimes have options for curative treatments that can extend their lives, particularly when they are diagnosed at stage 1 or 2.

Unfortunately, pericardial mesothelioma doesn’t have a formal staging system. This form of asbestos-related cancer is so rare it is usually diagnosed on the operating table or after death. Oncologists gauge the severity of the disease based on the size of the tumors that appear on the pericardium and whether or not those tumors can be surgically removed. When there is a formal diagnosis, the estimates are often based on general cancer-staging guidelines.

Pericardial Mesothelioma Prognosis

Less than 1 percent of mesothelioma patients are diagnosed with pericardial mesothelioma, and in most cases, this cancer is not discovered until after a patient is on the operating table or has already died. The prognosis for this disease is poor, as most patients live less than one year after diagnosis.

Treating Pericardial Mesothelioma

Patients who do receive a formal diagnosis of pericardial mesothelioma may have some treatment options to explore. Pericardiectomy is a commonly used procedure in which a portion of the heart lining is removed. It is often followed by a course of chemotherapy, usually with a drug called Cisplatin.

Those diagnosed in the later stages of the disease can take advantage of palliative treatments. Specific types of chemotherapy can slow the growth of tumors, helping to ease pain and improve breathing. During a procedure called pericardiocentesis, a doctor uses a needle and catheter to remove excess fluid buildup around the heart lining. In a similar operation called percutaneous balloon pericardiotomy, a balloon is attached to the end of the catheter. As the balloon inflates, it creates tiny holes in the pericardium, allowing more fluid to drain from the effusion.

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