金沢 正晴, 布川 徹, 武山 大也, 石橋 潤一

Masaharu KANAZAWA, Tohru NUNOKAWA, Daiya TAKEYAMA, Jun-ichi ISHIBASHI

東北労災病院循環器科

Division of Cardiology, Department of Internal Medicine, Tohoku Rousai Hospital

キーワード : Pericardium, Mesothelioma, Echocardiography, Cardiac catheterization, Angiography

A case of malignant pericardial mesothelioma is presented. A 37-year-old man had complained of pains in the anterior chest 3 months prior to admission. On admission, a chest X-ray film showed slight cardiomegaly, but an echocardiographic examination did not suggest any cardiac diseases. A month later when the cardiac enlargement became more marked, a large tumor was suggested by the routine echocardiography. When the probe was placed at the right sternal border in the 4th interspace in the right decubitus position, an egg-shaped, cystic mass measuring 7×10 cm in size was visualized anterior to the right heart, reaching to the aortic root. The mass was aechoic in the most parts, but there were some nodular echoes, too. The capsule appeared smooth. No definite signs of pericardial effusion were to be seen. These findings were thought to differ from those in the previous reports in which either pericardial effusions only were observed or tumors were diagnosed within the massive pericardial effusions.
From these echocardiographic findings, a pericardial tumor was suspected. A large amount of dark-red fluid containing fragments of soft tissues was proven at surgery. There were no signs of tumor infiltration out of the pericardium. The histopathological diagnosis was "malignant mesothelioma of the pericardium." The patient was discharged to resume his work after a course of oncolytic treatment.
Thus, echocardiography is useful to diagnose intrapericardial tumor.