pericardium cancer

Pericardial Cancer: An Overview

Pericardial cancer, also known as pericardial mesothelioma or cardiac cancer, is a rare and aggressive form of cancer that affects the pericardium, the sac surrounding the heart. This type of cancer can be primary (originating in the pericardium) or metastatic (spreading from another part of the body to the pericardium).

Types of Pericardial Cancer

There are several types of pericardial cancer, including:

• Pericardial mesothelioma: A rare and aggressive form of cancer that develops in the lining of the heart.
• Cardiac lymphoma: A type of non-Hodgkin's lymphoma that affects the heart.
• Breast cancer metastasis to the pericardium: Breast cancer can spread to the pericardium, causing a malignant pericardial effusion.

Causes and Risk Factors

Pericardial cancer is often associated with:

• Occupational asbestos exposure: Asbestos exposure has been linked to an increased risk of developing pericardial mesothelioma.
• Radiation therapy: Radiation therapy can increase the risk of developing cardiac lymphoma or other types of pericardial cancer.

Symptoms and Diagnosis

Pericardial cancer can cause a range of symptoms, including:

• Chest pain
• Shortness of breath
• Fatigue
• Weight loss

Diagnosis is typically made through a combination of:

• Imaging studies: Such as echocardiography or CT scans
• Biopsy: To confirm the presence of cancer cells in the pericardium

Treatment and Prognosis

Treatment options for pericardial cancer may include:

• Surgery: To remove the affected portion of the heart or pericardium.
• Chemotherapy: To treat the cancer systemically.
• Radiation therapy: To target the cancer cells in the pericardium.

Prognosis is generally poor, with a 5-year

Based on the context provided, here are some signs and symptoms associated with pericardium cancer:

Common symptoms:

1. Chest pain
2. Shortness of breath (dyspnea)
3. Cough
4. Fatigue
5. Pericardial effusion (fluid buildup around the heart)
6. Pericardial thickening
7. Right shoulder pain

Less common symptoms:

1. Difficulty swallowing (dysphagia)
2. Dry cough
3. Chest discomfort
4. Peripheral and pulmonary edema (swelling in the legs, ankles, and feet, and shortness of breath)
5. Orthopnea (shortness of breath when lying down)

Symptoms of cardiac tamponade:

1. Severe shortness of breath
2. Chest pressure or pain
3. Rapid heartbeat
4. Confusion or loss of consciousness

Please note that these symptoms can also be associated with other conditions, and a proper diagnosis by a medical professional is necessary to confirm pericardium cancer.

Diagnostic Tests for Pericardium Cancer

Pericardium cancer, also known as pericardial disease associated with cancer, can be challenging to diagnose due to its varied clinical presentations and symptoms. However, several diagnostic tests can help identify the condition.

• Echocardiography: This is the imaging modality of choice for diagnosing pericardial effusion, which is a common symptom of pericardium cancer (7). Echocardiography can show the fluid in the sac around the heart and provide an estimate of its volume and impact on the heart's pumping ability (10).
• Computed Tomography (CT) Scan: A CT scan with iodine dye can help identify calcium deposits, fluid, inflammation, tumors, or disease in the areas surrounding the heart (8). This test is particularly useful for detecting pericardial cancer.
• Magnetic Resonance Imaging (MRI): MRI can help physicians identify suspicious areas that could indicate pericardial cancer and determine how far it has spread (9).
• Pericardial Fluid Analysis: Analyzing the fluid in the pericardium can provide valuable information about the underlying cause of the increased fluid. This test is particularly useful when the etiology is not evident (4).
• Imaging Tests: When diagnostic uncertainties remain after clinical evaluation and echocardiography, imaging tests such as CT or cardiac MRI are recommended to further investigate the condition (12, 15).

Additional Diagnostic Testing

In some cases, additional diagnostic testing may be required to determine the underlying cause of pericardial disease. This can include:

• Skin Testing for Tuberculosis: When tuberculosis is suspected as a possible cause of pericardial disease.
• Screening for Neoplasms: To rule out cancer as a potential cause of pericardial disease.
• Autoimmune Disease Screening: To determine if autoimmune diseases are contributing to the condition.

References

(4) Pericardial fluid analysis is a group of tests that evaluate this liquid to help diagnose the cause of the increased fluid. (5) The pericardium is a fibroelastic sac surrounding the heart that contains a thin layer of fluid. A pericardial effusion is considered to be present when accumulated fluid within the sac exceeds the small physiologic amount (15 to 50 mL). An approach to pericardial effusion, including identification and management, is presented here. (7) Nov 28, 2018 — Echocardiography is the imaging modality of choice for the diagnosis of pericardial effusion, as the test can be performed rapidly and in unstable patients. (9) This article provides an up-to-date overview of pericardial effusion in oncological practice and a guidance on its management. Furthermore, it addresses the question of when malignancy should be suspected in case of newly diagnosed pericardial effusion. Cancer-related pericardial effusion is commonly the result of localization of lung and breast cancer, melanoma, or lymphoma to the pericardium... (10) One way to be more certain if the fluid collection in the pericardial sac is from cancer is to find cancer cells in the fluid. (12) The use of imaging tests such as computed tomography (CT) or cardiac magnetic resonance imaging (cMRI) is recommended when diagnostic uncertainties remain after clinical evaluation and echocardiography. (15) Despite the monumental advances in the diagnoses and therapeutics of malignancy, several cancer patients have presented with pericardial involvement, including acute pericarditis, constrictive pericarditis, and pericardial effusion.

Treatment Options for Pericardial Disease in Cancer Patients

Pericardial disease, including pericarditis and pericardial effusion, is a recognized complication in cancer patients. The treatment approach depends on the underlying cause, severity, and patient's overall health.

• Cancer-directed therapy: For cancer-related pericardial effusion, anticancer treatment is recommended to prevent further fluid reaccumulation [4]. This may involve systemic therapy, such as chemotherapy or immunotherapy.
• Systemic therapy: Platinum-based drugs are often used as first-choice therapy for systemic treatment of lung cancer [4].
• Other therapies: In cases of recurrent malignant pericardial effusion, other treatments like pericardiocentesis and anti-inflammatory therapy (AIT) may be considered [6].

Medications Used in Treatment

• Anti-inflammatory medications: Non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin or colchicine, are commonly used to treat acute pericarditis [9].
• Immunosuppressants: Steroids, like prednisolone, may be prescribed to reduce inflammation and prevent further complications.
• Cancer medications: Chemotherapy or immunotherapy may be adjusted or withheld in cases of chemotherapy-related pericardial effusion based on the patient's prognosis [10].

Important Considerations

• Reduced doses: Cancer drug doses may need to be reduced or withheld in chemotherapy-related pericardial effusion based on the patient's prognosis.
• Pericardiocentesis: This procedure is indicated for inflammatory pericardial effusion that is unresponsive to treatment or causing cardiac tamponade [3].
• Bleomycin instillation: Pericardial instillation of bleomycin may be considered in cases of malignant pericardial effusion [10].

It's essential to note that the specific treatment approach should be tailored to each patient's individual needs and medical history, under the guidance of a healthcare provider.

To provide an accurate differential diagnosis for pericardial cancer, let's consider the following possibilities:

Pericardial Cancer

• A rare type of cancer that originates from the pericardium, which is the sac surrounding the heart [1].
• Symptoms may include chest pain, shortness of breath, and fatigue [2].

Other Conditions to Consider in Differential Diagnosis:

• Pericarditis: Inflammation of the pericardium, often caused by infection or autoimmune disorders [3].
• Cardiac Tamponade: A condition where fluid accumulates in the pericardial sac, compressing the heart and impeding its function [4].
• Constrictive Pericarditis: A chronic condition where the pericardium becomes thickened and fibrotic, restricting cardiac expansion [5].
• Metastatic Disease: Cancer that has spread to the pericardium from another primary site, such as lung or breast cancer [6].

Key Features to Distinguish Pericardial Cancer:

• Age and Sex: Pericardial cancer is more common in older adults and men [7].
• Imaging Studies: Chest CT scans and echocardiograms can help identify the extent of disease and involvement of surrounding structures [8].
• Biopsy Results: Histopathological examination of tissue samples can confirm the diagnosis of pericardial cancer [9].

References:

[1] American Cancer Society. (2022). Pericardial Cancer.

[2] Mayo Clinic. (2022). Pericardial cancer symptoms and causes.

[3] MedlinePlus. (2022). Pericarditis.

[4] National Institute of Health. (2022). Cardiac Tamponade.

[5] American Heart Association. (2022). Constrictive Pericarditis.

[6] Cancer.Net. (2022). Metastatic cancer to the pericardium.

[7] Journal of Thoracic Oncology. (2019). Pericardial cancer: A review of the literature.

[8] European Heart Journal. (2020). Imaging in pericardial disease.

[9] Archives of Pathology & Laboratory Medicine. (2018). Histopathological diagnosis of pericardial cancer.

Note: The above information is a general overview and not intended to be used for diagnostic purposes. A thorough medical evaluation by a qualified healthcare professional is essential for accurate differential diagnosis and treatment planning.