Pericardial mesothelioma. A case report

Primary pericardial mesothelioma is a rare malignancy, with an estimated incidence of 0.0022% in a large autopsy study. We report a case of primary pericardial mesothelioma revealed by a large and recurrent pericardial effusion. Through a literature review, we analyse the clinical findings of this tumor. With or without therapy, prognosis is poor.     

Pericardial mesothelioma

The case of a 44-year old man, never exposed to asbestos, who died from a pericardial mesothelioma is described. The diagnosis was made by surgical examination. Two weak transient episodes of amelioration, the first accomplished with pronison administration and the other one by radiotherapy, were registered.     

Pericardial constriction caused by primary mesothelioma

Primary pericardial mesothelioma is an extremely rare tumour. This case illustrates the typical late presentation with symptoms and signs of constrictive pericarditis. An unusual feature was complete encasement of the heart by tumour. No satisfactory treatment is available.     

Pericardial mesothelioma presenting as constrictive pericarditis

A 46-year-old woman underwent pericardiocentesis and pericardial window for recurrent pericardial effusion. She presented 17 months later with signs and symptoms consistent with constrictive pericarditis. Cardiac magnetic resonance imaging revealed an infiltrative mass surrounding the pericardium. A transcutaneous core needle biopsy of the pericardium confirmed the diagnosis of pericardial mesothelioma.     

Pericardial constriction caused by primary mesothelioma.

Primary pericardial mesothelioma is an extremely rare tumour. This case illustrates the typical late presentation with symptoms and signs of constrictive pericarditis. An unusual feature was complete encasement of the heart by tumour. No satisfactory treatment is available.     

Pericardial mesothelioma presenting as systemic lupus erythematosus.

A case of mesothelioma of the pericardium with many features of systemic lupus erythematosus (SLE) is described. We stress that satisfaction of the American Rheumatism Association's classification criteria for SLE does not confirm the diagnosis, even though their diagnostic sensitivity and specificity has recently been improved.     

Pericardial tamponade complicating rheumatoid arthritis: a case report

BACKGROUND: Cardiovascular involvement in rheumatoid arthritis (RA) is increasingly observed and may be associated with the severity of rheumatoid arthritis. It is dominated by heart ischemic diseases related to atherosclerosis. Specific rheumatoid heart disease is commonly asymptomatic and found at autopsy or by echocardiography. Pericarditis is the commonest cardiac complication of RA. It is rarely clinically apparent and pericardial tamponade is exceptional. CASE REPORT: Herein, we report an unusual case of a 53-year-old female patient with a six-year history of seropositive and erosive rheumatoid arthritis who had developed a pericarditis complicated with tamponade resolved by pericardiocenthesis and high dose systemic steroids. Histopathology showed chronic inflammation and fibrosis. Under 1mg/day of colchicine, there were no recurrences at 10 months. CONCLUSION: Pericarditis is uncommon in rheumatoid arthritis. Forms with constriction or tamponade may have a fatal outcome. Pericardectomy usually recommended in constrictive forms, is sometimes indicated for tamponade. Some observations and randomised studies of idiopathic pericarditis suggest that colchicine may be interesting for the treatment and prevention of recurrences of rheumatoid arthritis-associated pericarditis.     

Pericardial cyst: case reports and a literature review

Pericardial cysts are rare mediastinal abnormalities, which are usually congenital but may also be acquired after cardiothoracic surgery. Cysts frequently occur in the right cardiophrenic angle and their diagnosis is usually suspected after an abnormal chest X ray is obtained. The presence of a pericardial cyst in this typical location or, less frequently, in an unusual location, poses a diagnostic challenge in distinguishing it from other intracardiac or mediastinal abnormalities. Two-dimensional echocardiography and transesophageal echocardiography are extremely valuable in diagnosing the presence of a pericardial cyst. Although most pericardial cysts are asymptomatic, patients may present with chest pain and dyspnea. In addition, life-threatening complications such as pericardial tamponade have been reported in association with pericardial cysts. The following cases illustrate the usefulness of two-dimensional echocardiography in making an accurate diagnosis of a pericardial cyst, as well as in follow-up of these patients for the development of possible complications. (ECHOCARDIOGRAPHY, Volume 21, April 2004)     

Pericardial hemolymphangioma. Apropos of a case

A case of pericardial hemolymphangioma revealed by palpitations is reported. X-ray films of the chest provided a diagnosis of mediastinal tumour. Full evaluation was performed using echocardiography, computerized tomography of the mediastinum, coronary arteriography and cardiac ventriculography. The tumour could be removed in toto. Pericardial hemolymphangioma is a rare benign vascular tumour. It is often discovered accidentally during examinations for non-suggestive cardiac functional disorders. The threat of compression or invasion of adjacent structures and that of hemopericardium by bleeding make surgical excision mandatory.     

Carbimazole and leukocytoclastic vasculitis: apropos of a case]

INTRODUCTION: The authors describe the case of biopsy-proven cutaneous leukocytoclastic vasculitis secondary to treatment with carbimazole. EXEGESIS: A 78-year-old white female developed erythematous macules on the lower limbs which cleared after discontinuation of her current treatment and implementation of oral steroid therapy. Causal explorations (lack of systemic disorder or infectious disease) remain negative, except for positive immune complexes. This case clearly differs from the two cases of microvasculitis (myositis and nephritis) secondary to treatment with carbimazole previously mentioned in the literature. CONCLUSION: To our knowledge this is the first report of biopsy-proven cutaneous leukocytoclastic vasculitis associated with this antithyroid agent. Its widespread use makes awareness of the side-effect important.     

Toxic dermatitis caused by pseudoephedrine: apropos of a case

Allergy to pseusoephedrine seems to be rare and has been described as responsible of urticaria, contact dermatitis, fixed non-pigmenting erythema or pseudoscarlatina. We report the case of a male patient who presented a recurrent erythema after administration of different treatments including pseudoephedrine. A cutaneous biopsy was compatible with erythema multiform. Patch tests confirmed the diagnosis of allergy to pseudoephedrine but resulted in a reappearance of symptoms.