Primary cardiac mesothelioma presenting with fulminant recurrent pericarditis: A case report

Shmuel Schwartzenberg*, Yaron Shapira, Victor Rubachevski, Ram Sharony

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Primary pericardial mesothelioma is an extremely rare disease. Prognosis is poor, with little effects of chemo-or radio-Therapy. The majority of cases is diagnosed at autopsy. Case summary: A 22-year-old man, who presented with recurrent pericarditis and large pericardial effusion 2 months after a second BNT162b2 COVID-19 vaccine, underwent pericardiocentesis and pericardial window. Pathology specimen of pericardium revealed benign mesothelial inflammation, consistent with acute pericarditis. Four months later, he presented with a large pericardial mass manifesting in heart failure and underwent urgent pericardiectomy. A new pathology specimen immunostaining and fluorescence in situ hybridization analysis revealed pericardial mesothelioma. Despite intensive care, the patient died 3 weeks later. Discussion: Primary pericardial mesothelial should be considered in the differential diagnosis of refractory recurrent pericarditis, even with prior biopsy-proven pericarditis or when a putative trigger (COVID-19 mRNA prior vaccination) is suspected, as was the case in this patient. Tumour diagnosis and identification consist of multimodal imaging and laboratory tests. A multidisciplinary, individualized care approach should be performed.

Original languageEnglish
Article numberytad100
JournalEuropean Heart Journal - Case Reports
Issue number3
StatePublished - 1 Mar 2023


  • Case report
  • Pericardial mesothelioma
  • Recurrent pericarditis
  • Transthoracic echocardiogram


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