Primary malignant pericardial mesothelioma is extremely rare, with a reported prevalence of 0.0022% at autopsy series. It is, however, the most common primary malignancy of the pericardium. To date, only few hundred cases have been reported in the literature. Unlike peritoneal and pleural mesothelioma, there has been no definite correlation between asbestos exposure and pericardial disease. Malignant pericardial mesothelioma carries a poor prognosis with no successful treatment strategies and little benefit from radiation and chemotherapy. We report a 28 year-old man with no medical history who presented with two weeks of worsening dyspnea on exertion to minimal efforts and severe orthopnea. We discuss the diagnostic approach and therapy in our patient and provide a review of the literature pertaining to the epidemiology, clinical features of pericardial mesothelioma and its diagnosis and treatment.
Key words: Cardiac neoplasm, Pericardium, Mesothelioma, Constrictive pericarditis.