Malignant Pericardial Mesothelioma Misdiagnosed as Constrictive Pericarditis

결핵성 심낭염으로 오인되어 치료한 악성 심낭 중피종

  • Kwak Jae Gun (Department of Thoracic and Vardiovascular Surgerym Seoul National University Hospital, Seoul National University College of Medicene) ;
  • Kim Kyung-Hwan (Department of Thoracic and Vardiovascular Surgerym Seoul National University Hospital, Seoul National University College of Medicene)
  • 곽재건 (서울대학교병원 흉부외과, 서울대학교 의과대학 흉부외과학실) ;
  • 김경환 (서울대학교병원 흉부외과, 서울대학교 의과대학 흉부외과학실)
  • Published : 2005.08.01

Abstract

We report aprimary malignant pericardial mesothelioma. Thirty-eight-year-old male patient complained of dyspnea and chest pain with left shoulder pain. At first, we thought it was because of tuberculous constrictive pericarditis and performed medical management for one and a half years. But, the above symptom recurred repeatedly; therefore we did pericardiectomy and diagnosed his case as malignant pericardial mesothelioma. Tumor was sticked to the myocardium and complete resection was impossible. He received postoperative chemoradiotherapy.

38세 남자 환자가 호흡곤란과 좌측의 어깨 통증을 주소로 내원하였다. 심장 초음파 등의 검사로 이의 원인을 결핵성 심낭염으로 판단하고 약 1년 반 동안 내과 치료를 하였다. 내과 치료에 반응하지 않아 심낭 절제술을 시행하였고, 이를 통한 조직 검사 결과 악성 심낭 중피종으로 진단하였다. 종양은 심외막 및 심근에 심하게 유착되어 있어 완전 절제는 불가능하였으며, 환자는 현재 항암제 치료를 받고있다.

Keywords

References

  1. Gossinger HD, Siostrzonek P, Zangeneh M, Neuhold A, Herold C, Schmoliner R. Magnetic resonance imaging findings in a patient with pericardial mesothelioma. Am Heart J 1988;115:1321-2 https://doi.org/10.1016/0002-8703(88)90033-6
  2. Antman KH, Corson JM, Li FP, et al. Malignant mesothelioma following radiation exposure. J Clin Oncol 1983;1:695- 700 https://doi.org/10.1200/JCO.1983.1.11.695
  3. Quinn DW, Qureshi F, Mitchell IM. Pericardial mesothelioma: The diagnostic dilemma of misleading imaging. Ann Thorac Surg 2000;69:1926-7 https://doi.org/10.1016/S0003-4975(00)01204-2
  4. Ohnishi J, Shiotani H, Ueno H, Fujita N, Matsunaga K. Primary pericardial mesothelioma demonstrated by magnetic resonance imaging. Jpn Circ J 1996;60:898-900 https://doi.org/10.1253/jcj.60.898
  5. Lund O, Hansen OK, Ardest S, Baadrup U. Primary malignant pericardial mesothelioma mimicking left atrial myxoma. Scand J Thorac Cardiovasc Surg 1987;21:273-5 https://doi.org/10.3109/14017438709106038
  6. Watanabe A, Sakata J, Kawamura H, Yamada O, Matsuyama T. Primary pericardial mesothelioma presenting as constrictive pericarditis. Jpn Circ J 2000;64:385-8 https://doi.org/10.1253/jcj.64.385