We presented a rare case of primary malignant
epithelioid type pericardial mesothelioma and
an undifferentiated nasopharyngeal carcinoma
diagnosed synchronously.
CASE REPORT: A patient was screened for
malignancy by computed tomography revealing
massive pericardial effusion, pericardial
thickening with mass and nodular lesions, and
mediastinal multiple lymphadenomegaly
suggesting preliminary diagnosis of
mesothelioma. Then, the patient underwent
FDG PET/CT scan to evaluate the metabolic
characterization of pericardial lesions and
staging of the disease. Intense FDG uptake in
diffuse pericardial thickenings, mildly FDG
uptake in pericardial fluid densities and
hypermetabolic lymph nodes in the
mediastinum were detected in PET/CT.
Interestingly, PET/CT revealed another
hypermetabolic mass in the nasopharynx
considered as a secondary primary malignant
lesion. He underwent radiotherapy for both
malignancies. In follow up, despite a complete
resolution of the nasopharyngeal carcinoma,
unfortunately the pericardial mesothelioma was
seen as metabolic stabile lesion.
DISCUSSION: This interesting case
highlighted the usefulness of FDG/PET in
pericardial mesothelioma for revealing unusual
metastatic sites and probable synchronous
malignancies.