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Primary Malignant Pericardial Mesothelioma (PMPM) Often Misdiagnosed

Mesothelioma is one of the deadliest cancers known to man. However, in just the last 10 years, diagnosis and treatment options have greatly improved. This is especially true when it comes to the form of mesothelioma and if the disease is caught early.

The most common form of mesothelioma is malignant pleural mesothelioma (MPM), accounting for approximately 75 to 80 percent of mesotheliomas. Early diagnosis of MPM, especially for people with known exposure to asbestos, is now possible with the help of imaging tests such as chest x-rays and computed tomography (CT) scans. According to the American Cancer Society (ACS), in recent years, doctors have also found that people with mesothelioma “often have high levels of certain substances in their blood, including osteopontin and soluble mesothelin-related peptides (SMRPs).”

“Blood tests for these substances may one day be useful in finding mesotheliomas early, as well as for monitoring the course of the disease in people who have mesothelioma,” says the ACS.

This is promising news for patients with MPM, but what about patients with one of the rarest forms of the disease—primary malignant pericardial mesothelioma (PMPM)? According to a recent analysis by researchers in the Department of Cardio-thoracic Surgery, Second Affiliated Hospital of Anhui Medical University, even with all of the advances in diagnosing MPM, PMPM still remains the most misdiagnosed tumor.

PMPM is one of the two rarest forms of mesothelioma (testicular mesothelioma is the rarest) and it begins in the lining around the heart, called the pericardium. Because PMPM is so rare and it often presents with symptoms similar to other diseases such as atrial myxoma, cardiomyopathy, coronary heart disease, heart failure, and tuberculosis, patients are often misdiagnosed and treated aggressively for the less rare conditions. By the time multiple treatments have been administered and fail, the disease has already reached its later stages, making it nearly impossible to treat.

In the study, researchers reported that although PMPM is extremely rare, it is the third most common tumor around the heart/pericardium, after angiosarcoma (33 percent) and rhabdomyosarcoma (20 percent). So when patients present with symptoms, the research team says PMPM should be considered. This will limit the number of misdiagnosed cases, helping doctors to diagnose the disease at an earlier stage, when treatments have the potential to be more effective.

If you have been exposed to asbestos, see your doctor right away. Even if you do not have symptoms, your doctor can administer tests and set up a monitoring plan that can help detect changes in the body sooner. Early detection leads to better treatment options and outcomes, so talk to your doctor today.



"Can Malignant Mesothelioma Be Found Early?" American Cancer Society. American Cancer Society, Inc., 17 Feb. 2016. Web. 29 May 2018.

Cancer.Net Editorial Board. "Mesothelioma: Introduction." Cancer.Net. American Society of Clinical Oncology (ASCO), 31 Aug. 2017. Web. 29 May 2018.

Zhao, Qiang, and Wenhui Gong. "Primary Malignant Pericardial Mesothelioma—a Rare Cause of Superior Vena Cava Thrombosis and Constrictive Pericarditis." U.S. National Library of Medicine (NLM). National Center for Biotechnology Information (NCBI), Dec. 2014. Web. 29 May 2018.