PERICARDIAL MESOTHELIOMA WITH THROMBOVASCULAR COMPLICATIONS (CASE FROM PRACTICE)

Primary mesothelioma of the pericardium is a rare heart tumor with a difficult diagnosis, revealed in vivo in less than a quarter of cases. The disease occurs at any age, more common in men and variably exhibits a broad spectrum of non-specific symptoms of congestive heart failure, constrictive peri...

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Main Authors: N. Yu. Karpova, N. S. Chipigina, K. A. Rogov, A. M. Sdvizhkov, M. A. Rashid, J. I. Banova, E. M. Levin
Format: Article
Language:Russian
Published: SINAPS LLC 2017-12-01
Series:Архивъ внутренней медицины
Subjects:
Online Access:https://www.medarhive.ru/jour/article/view/724
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author N. Yu. Karpova
N. S. Chipigina
K. A. Rogov
A. M. Sdvizhkov
M. A. Rashid
J. I. Banova
E. M. Levin
author_facet N. Yu. Karpova
N. S. Chipigina
K. A. Rogov
A. M. Sdvizhkov
M. A. Rashid
J. I. Banova
E. M. Levin
author_sort N. Yu. Karpova
collection DOAJ
description Primary mesothelioma of the pericardium is a rare heart tumor with a difficult diagnosis, revealed in vivo in less than a quarter of cases. The disease occurs at any age, more common in men and variably exhibits a broad spectrum of non-specific symptoms of congestive heart failure, constrictive pericarditis, pericardial effusion or cardiac tamponade. Patients are usually observed with peripheral edema, ascites, dyspnea, cough, chest pain and atrial fibrillation. Such symptoms, in the absence of cancer alertness, are erroneously attributed by doctors to more common cardiovascular diseases. As a result, primary mesothelioma is detected in 75-90% of cases only at necropsy. The article describes a case of detection at autopsy of primary pericardial mesothelioma sarcomatous type with invasion into the myocardium in a patient of 74 years old. The patient also suffered from concomitant coronary artery disease with a long history of chronic heart failure and recurrent pulmonary embolism, associated with deep vein thrombosis at the final stage of the disease. An objective study revealed signs of chronic heart failure. The laboratory data included mild iron deficiency anemia, insignificant leukocytosis and leukocyturia, as well as signs of moderate chronic kidney disease. Instrumental results corresponded to long-term course of hypertension, signs of congestive heart failure in the presence of atrial fibrillation, atherosclerosis of lower limbs arteries in patient with abdominal obesity. Thus, there were no clinical signs of pericardial damage in a standard examination of the patient. The article describes the complexity of the disease diagnosis, variable clinical picture, as well as the diagnostic value of various instrumental methods from the perspective of evidence-based medicine. It is noted that clinical alertness is still the most important factor in the lifetime diagnosis of pericardial mesothelioma. Disease should be considered in patients with recurrent pericardial effusion, constrictive pericarditis, pericardial mass or thickening of pericardium leaflets. For reliable diagnosis of a tumor, modern imaging studies and histological examination are required.
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spelling doaj.art-0e191c70c3434d9194dcb7d72e20b1d02025-03-02T12:48:59ZrusSINAPS LLCАрхивъ внутренней медицины2226-67042411-65642017-12-017647447910.20514/2226-6704-2017-7-6-474-479648PERICARDIAL MESOTHELIOMA WITH THROMBOVASCULAR COMPLICATIONS (CASE FROM PRACTICE)N. Yu. Karpova0N. S. Chipigina1K. A. Rogov2A. M. Sdvizhkov3M. A. Rashid4J. I. Banova5E. M. Levin6Federal State Budget Educational Institution of Higher Education «Russian National Research Medical University named after NI Pirogov» of the Ministry of Health of the Russian Federation.Federal State Budget Educational Institution of Higher Education «Russian National Research Medical University named after NI Pirogov» of the Ministry of Health of the Russian Federation.Federal State Budgetary Research Institute of Human Morphology.The State Budgetary Healthcare Institution «Oncological Clinical Dispensary № 1 of the Moscow City Health Department».The State Budgetary Healthcare Institution «Oncological Clinical Dispensary № 1 of the Moscow City Health Department».The State Budgetary Healthcare Institution «Oncological Clinical Dispensary № 1 of the Moscow City Health Department».The State Budget Health Institution «Psychiatric Clinical Hospital No. 1 named after N.A. Alexeyev of the Moscow City Health Department».Primary mesothelioma of the pericardium is a rare heart tumor with a difficult diagnosis, revealed in vivo in less than a quarter of cases. The disease occurs at any age, more common in men and variably exhibits a broad spectrum of non-specific symptoms of congestive heart failure, constrictive pericarditis, pericardial effusion or cardiac tamponade. Patients are usually observed with peripheral edema, ascites, dyspnea, cough, chest pain and atrial fibrillation. Such symptoms, in the absence of cancer alertness, are erroneously attributed by doctors to more common cardiovascular diseases. As a result, primary mesothelioma is detected in 75-90% of cases only at necropsy. The article describes a case of detection at autopsy of primary pericardial mesothelioma sarcomatous type with invasion into the myocardium in a patient of 74 years old. The patient also suffered from concomitant coronary artery disease with a long history of chronic heart failure and recurrent pulmonary embolism, associated with deep vein thrombosis at the final stage of the disease. An objective study revealed signs of chronic heart failure. The laboratory data included mild iron deficiency anemia, insignificant leukocytosis and leukocyturia, as well as signs of moderate chronic kidney disease. Instrumental results corresponded to long-term course of hypertension, signs of congestive heart failure in the presence of atrial fibrillation, atherosclerosis of lower limbs arteries in patient with abdominal obesity. Thus, there were no clinical signs of pericardial damage in a standard examination of the patient. The article describes the complexity of the disease diagnosis, variable clinical picture, as well as the diagnostic value of various instrumental methods from the perspective of evidence-based medicine. It is noted that clinical alertness is still the most important factor in the lifetime diagnosis of pericardial mesothelioma. Disease should be considered in patients with recurrent pericardial effusion, constrictive pericarditis, pericardial mass or thickening of pericardium leaflets. For reliable diagnosis of a tumor, modern imaging studies and histological examination are required.https://www.medarhive.ru/jour/article/view/724heart tumorspericardiummesotheliomacongestive heart failurepulmonary embolismelderly
spellingShingle N. Yu. Karpova
N. S. Chipigina
K. A. Rogov
A. M. Sdvizhkov
M. A. Rashid
J. I. Banova
E. M. Levin
PERICARDIAL MESOTHELIOMA WITH THROMBOVASCULAR COMPLICATIONS (CASE FROM PRACTICE)
Архивъ внутренней медицины
heart tumors
pericardium
mesothelioma
congestive heart failure
pulmonary embolism
elderly
title PERICARDIAL MESOTHELIOMA WITH THROMBOVASCULAR COMPLICATIONS (CASE FROM PRACTICE)
title_full PERICARDIAL MESOTHELIOMA WITH THROMBOVASCULAR COMPLICATIONS (CASE FROM PRACTICE)
title_fullStr PERICARDIAL MESOTHELIOMA WITH THROMBOVASCULAR COMPLICATIONS (CASE FROM PRACTICE)
title_full_unstemmed PERICARDIAL MESOTHELIOMA WITH THROMBOVASCULAR COMPLICATIONS (CASE FROM PRACTICE)
title_short PERICARDIAL MESOTHELIOMA WITH THROMBOVASCULAR COMPLICATIONS (CASE FROM PRACTICE)
title_sort pericardial mesothelioma with thrombovascular complications case from practice
topic heart tumors
pericardium
mesothelioma
congestive heart failure
pulmonary embolism
elderly
url https://www.medarhive.ru/jour/article/view/724
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AT nschipigina pericardialmesotheliomawiththrombovascularcomplicationscasefrompractice
AT karogov pericardialmesotheliomawiththrombovascularcomplicationscasefrompractice
AT amsdvizhkov pericardialmesotheliomawiththrombovascularcomplicationscasefrompractice
AT marashid pericardialmesotheliomawiththrombovascularcomplicationscasefrompractice
AT jibanova pericardialmesotheliomawiththrombovascularcomplicationscasefrompractice
AT emlevin pericardialmesotheliomawiththrombovascularcomplicationscasefrompractice