Pericardial Mesothelioma | Symptoms, Causes and Treatment Options

The Pericardial Mesothelioma is a very rare form of the mesothelioma cancer that focuses on the lining of the heart, in other words, the Pericardium. There are only 150 diagnosed cases of this type of the mesothelioma cancer. Common symptoms among patients living in this health condition include irregular heartbeat, chest pain and breathing difficulties.

Pericardial Mesothelioma | Symptoms, Causes and Treatment Options
Image credit –

The Pericardial Mesothelioma

Medical researchers continue to try as much as possible to trace the link between asbestos and the pericardial cancer, even though almost all mesothelioma cancers can be traced to an exposure to asbestos. Studies have shown that about 25% of people living with this rare form of cancer have a history of being exposed to asbestos. Studies are less clear on how inhaled asbestos fibers can reach the heart, although they are very clear on how these fibers can reach the lungs.

With the median age being 55 years, research has shown that this form of mesothelioma is mostly being diagnosed in individuals between the ages of 50 and 70 years. According to the result of a study published in the journal of Clinical Oncology in 2017, approximately 60% of these cases are found to occur in men.

Similar to the other type of the mesothelioma cancer, the disease is typically discovered at later stages years after exposure to asbestos. Common symptoms of this critical health condition include fatigue, chest pain and shortness of breath. Due to the fact that these symptoms are similar to those of some other heart disorders, the diagnosis is often quite difficult.

The treatment option involved in this case include chemotherapy, palliative treatments to control and ease effects of the symptoms, radiation therapy (very rarely used), and surgical operations. With about 46% of patients choosing to undergo surgery, it happens to be the most common treatment option in use. On the other hand, about 37% of patients receive chemotherapy while only about 8% receive radiation therapy because of the high risks involved with radiation near the heart. Research has shown that for various reasons, nearly 25% of patients in this health condition choose not to undergo treatment of any kind at all.

In 2021, a research study reported that patients with primary stages of the pericardial mesothelioma have a median survival of about two months. However, after undergoing chemotherapy or surgery, some patients have lived with this cancer for years.

Researcher have reported that till date, less than 150 (which is about 1%) of all known cases of pericardial mesothelioma are being described in medical literature.

Symptoms Associated with Pericardial Mesothelioma

The major reason that contributes to a late stage diagnosis of this form of the mesothelioma disease is the fact that the symptoms do not manifest when the cancer initially develops. The symptoms are also similar to those of other heart conditions and this makes accurate diagnosis quite difficult.

Most of the symptoms are as a result of thickening of the pericardial layers and buildup of fluid around the heart. Once there are signs of any of these symptoms, it is advised to follow it up immediately with a visit to a physician who will in turn recommend screenings such as a CT scan, echocardiogram (ultrasound of the heart) or an X-ray test.

The following are some of the common symptoms that may indicate pericardial mesothelioma:

  • Pain in the chest
  • Fatigue
  • Fever
  • Night sweats
  • Irregular heartbeat (arrhythmia) or heart palpitations
  • Murmurs
  • Cough
  • Shortness of breath mostly when lying in a flat position
  • Breathing difficulties, even when at rest (dyspnea)

You need to schedule an immediate appointment with your doctor or a physician if you find yourself experiencing any of these symptoms. The underlying cause of these health problems can usually be revealed through accurate screening tests like CT scans, echocardiograms or X-rays.

Causes of the Pericardial Mesothelioma

Till date, the primary cause of this health condition remains a mystery. The definitive relationship between an exposure to asbestos and other types of mesothelioma diseases are clear, but not for this pericardial mesothelioma cancer. This is so because researchers have confirmed asbestos exposure as the primary cause of pleural and peritoneal mesotheliomas, yet the cause of the pericardial mesothelioma remains less definitive.

In 2017, a review of medical literature suggested asbestos exposure in 25% of cases with this pericardial cancer. But yet in another study published in the same year, the Annals of Epidemiology reported that majority of the patients with the pericardial mesothelioma showed no history of exposure to asbestos.

You may want to >>> Learn more about Asbestos Exposure

Diagnosis of the Pericardial Mesothelioma

In order to give an accurate diagnosis of pericardial mesothelioma, physicians usually make an overall assessment of the symptoms shown, current medical condition and medical history of the patient. After that, a physical examination will be conducted, biopsy, and imaging tests to determine the location of the tumors and confirm whether or not they cancerous.

One of the very first diagnostic tests you will usually receive is an echocardiogram, which is basically an ultrasound for your heart, whenever you get to discuss heart-related symptoms with your doctor. The doctor gets to see the shape and size of your heart and determine how well it is functioning overall, with the aid of this noninvasive test that uses sound waves to operate.

Other imaging scan are also needed to determine if potential tumors are present, although an echocardiogram can usually reveal any buildup of fluid around the heart and help guide a pericardiocentesis, which is the procedure doctors perform to drain out the fluid. If any abnormal growth is spotted by doctors, they usually need to take samples of the fluid or tissue for a biopsy testing, which can then help confirm a mesothelioma diagnosis.

Physical Examination

Most of the cases of Pericardial Mesothelioma unfortunately, are only found at autopsy. About 10 – 20% of these cases nonetheless, are diagnosed before the patient dies. Some of the major challenges with accurate and early diagnosis of this type of the cancer include the late manifestation of symptoms and the very little amount of patients with the disease.

Imaging Tests

Computed Tomography (CT) scans have proven to be very effective in detecting the pericardial tumors, which makes them the most preferred tool for diagnosis. Also, the Magnetic Resonance Imaging (MRI) scan can help yield successful results in the identification of the cancer tumors.

A detection method known as Radionuclide that involves the injection of gallium, radioactive material, in order to identify cancerous cells can also be carried out. It was reported to have been used in at least one case of this type of mesothelioma cancer. Possible tumor sites in the human body can be revealed by some patterns of radioactivity.


In determining the point of origin of the cancer, this crucial diagnostic procedure can be more suitable. A surgeon will usually remove samples of fluid or tissue from the pericardium, and examine its cells under a microscope in order to positively confirm the presence of the pericardial mesothelioma. According to a study in the Journal of Cardiac Failure in 2016, fluid biopsies often turn out to be free of cancer, even with the presence of pericardial tumors. To confirm pericardial mesothelioma, a tissue sample of the tumor itself is usually required.

Avoiding Misdiagnosis

It is very crucial to confirm your diagnosis from a specialist, because the pericardial mesothelioma symptoms such as cough, breathing difficulties and chest pain are shared with various other diseases. To ensure prompt treatment and an accurate diagnosis, you need to consult with an expert who knows the intricacies of this rare form of cancer.

The Pericardial Mesothelioma is usually mistaken for more common health conditions that are not asbestos-related, such as:

  • Cardiac tamponade
  • Intra-atrial myxoma
  • Cardiomyopathy
  • Tuberculosis pericarditis
  • Constrictive pericarditis
  • Heart failure
  • Coronary heart disease

Always seek the attention of a specialist if you have been diagnosed with any of these health conditions. You may get access to a wider range of options, and even improved survival when you work with a specialist.

Pericardial Mesothelioma – Available Treatment Options

Owing to the fact that the heart lining rests very close to the heart itself, and most therapies may easily damage this delicate organ, treatment options are quite limited for this form of mesothelioma cancer. A little above half of all pericardial mesothelioma patients are not eligible for surgery, which is often the most effective treatment option for this condition, based on reports by researchers. However, there are rare cases of early diagnosis of the cancer, and surgery can be done to remove the localized small tumors.

The major treatment options available for the pericardial mesothelioma are chemotherapy, pericardiectomy (tumor removal) and other palliative treatment like the fine needle aspiration. Radiation therapy is considered to be risky to administer without causing dangerous harm to the heart itself, and minimally effective for this rare form of cancer when tried.

Pericardiectomy (Tumor removal)

This process is undergone by patients whose physicians have checked and confirmed that they are good enough for surgery. It is a surgical process that involves removal of all or part of the pericardium. Pericardiectomy can help relieve minimized buildup of fluid and pressure, allowing continued proper functioning of the heart.

This removal of tumor can also involve the removal of the cancer without removing the pericardium. In 2017, a review reported that patients who went through this process of tumor removal experienced longer survival than those who had a Pericardiectomy.


For most patients with pericardial mesothelioma, the benefits of chemotherapy are minimal. The drugs (cisplatin and pemetrexed) used for this chemotherapy have exhibited survival benefits, and on the other hand, gemcitabine has also produced mixed results. Only but a handful of these cases have shown a positive response to chemotherapy. A case of an old lady was revealed, that she was able to live longer than two years, all thanks to a combination of the chemotherapy drugs vinorelbine, gemcitabine and cisplatin.

A new checkpoint inhibitor form of immunotherapy called Pembrolizumab, has also shown some benefits in cases of the pericardial mesothelioma.

Palliative Treatment

This form of treatment usually aims to reduce effects of the symptoms caused by fluid buildup in the pericardium and minimize pain being experienced by the patient. Palliative care can essentially make patients more comfortable and improve quality of life.

These palliative treatments can include therapies that relieve pressure and pain around the heart such as pain medication or pericardiocentesis. A pericardiocentesis helps in the removal of excess fluid from the pericardium, to relieve pressure around the heart.

Ensure to see a health specialist if you suspect any of the symptoms of the cancerous pericardial mesothelioma disease, for proper checkup, diagnosis and possible treatment.

Leave a Reply

Your email address will not be published.