CTICasesPrimary Pericardial Mesothelioma
Imaging findings
A young patient presenting with dyspnea and chest pain has an enlarged, globular cardiac silhouette on radiograph consistent with a large pericardial effusion; pericardiocentesis yields bloody fluid. Just six weeks later, follow-up imaging shows a large, infiltrative intrapericardial soft-tissue mass that was not previously present, with extensive uptake on PET/CT and MRI enhancement.
Key takeaways
Rapid development of a bulky, infiltrative pericardial soft-tissue mass within weeks of an initially unremarkable pericardial effusion is characteristic of primary pericardial mesothelioma, the most common primary pericardial tumor; unlike pleural mesothelioma, an asbestos exposure history is identified in only a minority of reported cases, and the disease carries a poor prognosis.
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