Multimodal Diagnostic Workup of Primary Pericardial Mesothelioma: A Case Report

Background: Primary pericardial mesothelioma is an extremely rare tumor, and early identification and accurate diagnosis may improve its clinical outcome.Case presentation: In this study, we reported a case of a 70-year-old woman who presented with dyspnea. Conventional transthoracic echocardiography showed massive pericardial effusion. Contrast-enhanced ultrasonography revealed a hyper-enhancing mass in the pericardium. Further imaging methods, including cardiac MRI and positron emission tomography/computed tomography, showed invasion of the pericardial mass into the adjacent tissues and distant metastases. Pathologic examination of a puncture biopsy specimen finally confirmed the diagnosis of PPM.Conclusion: Pericardial masses are difficult to detect when a large amount of pericardial effusion is present and the mass is small. The combination of multiple modalities plays a meaningful role in identifying PPM.

Automated summary

Primary pericardial mesothelioma is an extremely rare tumor, and early identification and accurate diagnosis are crucial for improving clinical outcomes. This case report described a 70-year-old female patient presenting with dyspnea, and confirmed the diagnosis through a combination of multiple imaging modalities.