Key Takeaways
- Pericardial mesothelioma is a rare, aggressive cancer that develops in the mesothelium — the tissue lining that surrounds the heart. It accounts for only 1 to 2% of all mesothelioma cases.
- Known risk factors include asbestos exposure (occupational or environmental), extensive radiation exposure to the chest area, tuberculosis, and certain carcinogenic agents previously used in medical scanning.
- Symptoms include fatigue, difficulty breathing, chest pain, persistent cough, nondescript heart problems, and pericardial effusion (excess fluid around the heart). Because these symptoms overlap with many other conditions, pericardial mesothelioma is often not diagnosed until after death.
- The only way to receive a definitive diagnosis is through a histological assessment — a direct examination of tissue from the mesothelium around the heart. Visual imaging like echocardiograms and CT scans can identify a problem but cannot confirm this specific cancer on their own.
- The median age of diagnosis is 55 years. There is no unanimous treatment plan — surgery and chemotherapy used together may improve prognosis if detected early, but chemotherapy alone is the only approach shown to significantly increase survival.
- The projected life expectancy is approximately six months after diagnosis, both with and without medical intervention.
What is it?
This type of mesothelioma is an aggressive cancer of the tissues (mesothelium) surrounding the
heart. It is associated with asbestos exposure, either environmentally or occupationally. Other
probable causes for pericardial mesothelioma are extensive exposure to radiation (especially
around the chest area), tuberculosis, and certain carcinogenic agents previously used in medical
scanning. Less is understood about how pericardial mesothelioma develops, as some
epidemiological studies present conflicting evidence about asbestos exposure as a risk factor for
onset.
Symptoms usually present as general fatigue, difficulty breathing, nondescript heart problems,
pericardial effusion (which is an excess of fluid in the area surrounding the heart), chest pain,
and persistent cough. Because the symptoms align with other diseases and cancers, pericardial
mesothelioma is an elusive cancer; sometimes, it isn’t diagnosed until after death. Diagnostic
measures include echocardiograms (which visualize the heart via ultrasound), CT scans, biopsy
(an extracted sample of living tissue from the affected area), and histology tests (which are
examinations of tissues sourced directly from the mesothelium around the heart). The only way
to receive a definitive pericardial mesothelioma diagnosis is for a histological assessment. While
visual techniques help initially identify a problem, there’s no way to guarantee one diagnosis
over another, especially considering how rare pericardial mesothelioma is.
The median age of diagnosis is 55 and there is not a specified or unanimous treatment plan.
Oftentimes, surgery and chemotherapy used in conjunction increase a patient’s prognosis,
especially if the cancer is detected early. While surgery (resectable approach) might initially
help, chemotherapy is the only treatment approach that resulted in significant increases of
survival (McGehee et al.). The projected life expectancy is six months after a diagnosis of
pericardial mesothelioma, both with and without medical intervention.
What is the Difference Between Pericardial and Pleural Mesothelioma?
Compared to malignant pleural mesothelioma (MPM), which accounts for about 50-70% of all
mesothelioma cases, this type of mesothelioma accounts for about 1-2% of all mesothelioma
cases. And, while pleural mesothelioma arises in the tissues surrounding the lungs, pericardial
mesothelioma arises around the heart. Both cancers could metastasize, or spread beyond their
initial affected area, into the other because of their close proximity to each other.
More is known about the risk factors associated with pleural mesothelioma, with asbestos
exposure being the most pertinent. Because of the relative rarity of it, there has been a notable lack in the literature about ways to quickly and accurately diagnose it.
Because of this, treatment options are much more limited and require more research. There have
only been a few longitudinal/retrospective studies detailing specific case studies of pericardial
mesothelioma, so it would be useful for a contemporary review of these cases.
If you or a loved one has been diagnosed with an asbestos-related disease, please call
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Frequently Asked Questions
What is pericardial mesothelioma?
Pericardial mesothelioma is a rare and aggressive cancer that develops in the pericardium — the thin tissue lining that surrounds the heart. It accounts for approximately 1 to 2% of all mesothelioma cases, making it one of the rarest forms of the disease. Like other types of mesothelioma, it is associated with asbestos exposure, though other risk factors — including radiation and certain carcinogenic agents — have also been identified.
What causes pericardial mesothelioma?
The primary known risk factors include:
- Asbestos exposure — either occupational (workplace) or environmental
- Extensive radiation exposure — particularly to the chest area
- Tuberculosis
- Certain carcinogenic agents previously used in medical scanning
However, less is understood about how pericardial mesothelioma develops compared to pleural mesothelioma. Some epidemiological studies have presented conflicting evidence about asbestos exposure as a direct risk factor for this specific type, and more research is needed.
What are the symptoms of pericardial mesothelioma?
Symptoms typically include general fatigue, difficulty breathing, chest pain, persistent cough, nondescript heart problems, and pericardial effusion (excess fluid buildup around the heart). Because these symptoms closely mimic other cardiac and respiratory conditions, pericardial mesothelioma is extremely difficult to diagnose — and in some cases, is not identified until after the patient has died.
How is pericardial mesothelioma diagnosed?
Diagnostic methods include:
- Echocardiogram — uses ultrasound to visualize the heart and surrounding tissues
- CT scan — provides detailed cross-sectional images of the chest
- Biopsy — extracts a sample of living tissue from the affected area
- Histological assessment — a direct microscopic examination of tissue from the mesothelium around the heart
While imaging tests can initially identify a problem, a histological assessment is the only way to receive a definitive diagnosis of pericardial mesothelioma. Given how rare the disease is, doctors cannot distinguish it from other conditions based on imaging or symptoms alone.
What treatment options are available for pericardial mesothelioma?
There is currently no single treatment plan that has been established as consistently effective for pericardial mesothelioma. Surgery and chemotherapy used together may improve prognosis, especially if the cancer is detected early. However, research has shown that chemotherapy is the only treatment approach that has resulted in significant increases in survival. Clinical trials and combination therapies continue to be explored, but the rarity of the disease means that large-scale studies are limited.
What is the life expectancy for pericardial mesothelioma?
The projected life expectancy after a pericardial mesothelioma diagnosis is approximately six months, both with and without medical intervention. The aggressive nature of the cancer, combined with its location around the heart and the difficulty of early detection, contributes to this challenging prognosis. Early detection — while rare — offers the best chance for extending survival through surgical and chemotherapy combinations.
How is pericardial mesothelioma different from pleural mesothelioma?
The two types differ in several key ways:
- Location — pleural mesothelioma develops in the lining of the lungs; pericardial develops in the lining of the heart
- Prevalence — pleural accounts for 50–70% of all mesothelioma cases; pericardial accounts for only 1–2%
- Research — far more is known about pleural mesothelioma’s risk factors, diagnosis, and treatment options
- Prognosis — pericardial mesothelioma generally has a more challenging prognosis and fewer proven treatment options
Because of their close proximity, both cancers can potentially metastasize (spread) into each other’s region.
What should I do if I or a loved one has been diagnosed with pericardial mesothelioma?
If you or a loved one has been diagnosed with pericardial mesothelioma or another asbestos-related disease, understanding your treatment options and legal rights is an important first step. Even though pericardial mesothelioma is rare, your asbestos or radiation exposure history may be central to a legal claim. Call (800) 505-6000 or fill out our contact form for a free consultation.
