Butz Thomas, Faber Lothar, Langer Christoph, Körfer Jan, Lindner Oliver, Tannapfel Andrea, Müller Klaus-Michael, Meissner Axel, Plehn Gunnar, Trappe Hans-Joachim, Horstkotte Dieter, Piper Cornelia
J Med Case Rep. 2009 Sep 17;3:9256. doi: 10.4076/1752-1947-3-9256.
Primary malignant pericardial mesothelioma is a very rare pericardial tumor of unknown etiology.
A 61-year-old Caucasian woman was admitted to our hospital complaining of exertional dyspnea due to a large pericardial effusion. Intrapericardial fluid volume declined after repeated pericardiocentesis, but the patient progressively developed a hemodynamically relevant pericardial constriction. Pericardiectomy revealed a pericardial mesothelioma. Subsequently, four cycles of chemotherapy (dosage according to recently published trials) were administered. The patient remained asymptomatic, and there was no recurrence of the tumor after three years.
Pericardial mesothelioma should be considered and managed appropriately in non-responders to pericardiocentesis, and in patients who develop constrictive pericarditis late in their clinical course.
原发性恶性心包间皮瘤是一种病因不明的极为罕见的心包肿瘤。
一名61岁的白种女性因大量心包积液导致劳力性呼吸困难入住我院。反复心包穿刺后心包内液体量减少,但患者逐渐出现血流动力学相关的心包缩窄。心包切除术显示为心包间皮瘤。随后,给予四个周期的化疗(剂量根据最近发表的试验)。患者保持无症状,三年后肿瘤未复发。
对于心包穿刺无反应以及在临床病程后期发生缩窄性心包炎的患者,应考虑并适当处理心包间皮瘤。