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Primary malignancies arising from the pericardium are rare, even more unusual for primary pericardial mesothelioma. The diagnosis is difficult and has no standard treatment. We herein present a case of a 65-year-old woman with primary pericardial mesothelioma associated with dyspnoea and palpitations. Transthoracic conventional echocardiography revealed mild pericardial effusion and a hypo-echogenic mass in the pericardium. Contrast echocardiography showed that the mass was hyper-enhanced with a radial enhancement pattern. The patient underwent open chest exploration and was diagnosed by pathological examination. She had no further treatment and died 2 years later. In conclusion, the combination of conventional echocardiography and contrast echocardiography plays a significant role in diagnosing primary pericardial mesothelioma. Comprehensive evaluation and accurately preoperative diagnosis are important to exclude certain tumours that do not require surgery.

Diagnosis of a primary pericardial mesothelioma by the combination of conventional echocardiography and contrast echocardiography