Primary 1 Case Of Primary Pericardial Mesothelioma And Literature Review

Primary Pericardial Mesothelioma(PPM)is a very rare pericardial tumor developed in mesothelial cells,due to special parts,are malignant,also known as primary malignant pericardial mesothelioma(Primary Malignant Pericardial Mesothelioma,PMPM).The incidence of PMPM is extremely low,with <0.0022% of cases reported in a large-scale autopsy study.Men more common,the age of onset in 12~77 years old,the average age of 47 years old.The cause of primary pericardial mesothelioma is still not clear.The symptoms and signs often manifested as dyspnea,cough,chest tightness,chest pain,palpitations,dizziness,fatigue,jugular vein engorgement,edema,hepatomegaly,odd pulse and other cardiac tamponade performance,when the tumor involving the heart conduction system can cause Arrhythmia and even sudden death.Because of its symptoms and signs of atypical and non-specific,easily misdiagnosed or delayed diagnosis.Need to CT,MRI,PET-CT and other multi-modal imaging method to assist the diagnosis.Adequately in pericardial effusion cytology diagnosis is very difficult,mesothelioma for the two-way differentiation of the tumor,the epithelium or sarcoma differentiation mainly difficult to diagnose,immunohistochemical markers become the main point of diagnosis,but mesothelioma cells There are no specific markers for diagnosis.inal diagnosis requires pathology.Symptoms,imaging and pathological combined with immunohistochemical results,diagnostic PMPM.For patients with definite diagnosis,surgery is the most important treatment.There is no systematic clinical trials of reliable chemotherapy,the effectiveness of systemic chemotherapy through the case report to prove.There is currently no large-scale clinical trials of chemotherapy or radiotherapy,and the level of evidence for these treatments is quite low.Although radiotherapy and chemotherapy have not been shown to be beneficial,both are still used for adjuvant therapy in patients with incomplete tumor resection.The median survival time of patients with pericardial mesothelioma is approximately 6 months and the prognosis is poor.This case report provides a 48-year-old woman with recurrent pericardial effusion.The initial symptoms of non-specific,the performance of activities after chest tightness,asthma symptoms.After pericardial puncture,but the detection of malignant cells and tuberculosis was negative.Disease development after the emergence of tumor infiltration performance,ultrasound-guided puncture,histopathological examination,including immunohistochemical staining suggest malignant mesothelioma.Diagnosis is clear,thoracic surgery consultation without surgery.To be "pemetrexed(500mg/m2)" program chemotherapy 6 times,the patient's condition improved.After the short term to progress again,and the emergence of superior vena cava obstruction syndrome,adjust the program topemetrexed "(500mg/m2)+ cisplatin(75mg/m2)" chemotherapy 4 times,resulting in II degrees of bone marrow suppression performance.To be elevated after white blood cell therapy improved,continue to chemotherapy,the performance of positive reactions to it.