Case Description: Herein, we report the case of a 57-year-old female who developed chest tightness and panic for no obvious reason. She was diagnosed with
tuberculous pericarditis via multiple examinations including positron emission tomography/computed tomography (PET/CT), pleural biochemical routine,
tuberculin purified
protein derivative (
PPD) test, T cell spot (T-SPOT) test, and echocardiography, and was experienced intermittent relief after anti-
tuberculosis treatment. On 21 July, 2020,
pericardiectomy was performed due to poor
therapeutic effect, and the postoperative pathological diagnosis was
malignant mesothelioma. After discussing treatment plans and considering the prognosis, the patient opted for
palliative care. Subsequently, her symptoms gradually worsened, with chest tightness,
shortness of breath, palpitations at rest, frequent arrhythmias,
heart failure,
cardiogenic shock, and multiple plasma chamber effusions. This case showed that the most common misdiagnosis of PMPM is
tuberculous pericarditis, which needs to be differentiated from pleural
mesothelioma with pericardial
metastasis.
Conclusions: The diagnosis of PMPM is usually made by pathologic surgery or histopathological examination to determine the specific disease location. In addition, pericardiocentesis fluid exfoliation cytology, imaging and echocardiography can assist diagnosis. Due to the lack of effective treatment for PMPM, timely surgery and postoperative
adjuvant chemotherapy are needed to improve the quality of life of patients and prolong their survival time.