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Pericardial Mesothelioma

Pericardial mesothelioma is a rare form of cancer that affects the lining of the heart, which is also known as the pericardium. It is the rarest of the three main types of mesothelioma, making up less than 1% of all cases. It also has the shortest life expectancy. However, new treatments may help patients live longer.

Medically reviewed by: Mark Levin, MD

Last updated:

What Is Pericardial Mesothelioma?

Pericardial mesothelioma is a rare kind of mesothelioma cancer that forms in the sac-like lining surrounding the heart (the pericardium).

Because of its rarity, how difficult it is to detect, and how close it is to the heart, pericardial mesothelioma has the poorest prognosis of all mesothelioma types. However, treatment may help extend a patient’s life and make them more comfortable.

Quick Facts About Pericardial Mesothelioma
  • Fewer than 1% of mesothelioma patients have this type, according to a 2023 Modern Pathology study
  • Only 350 cases of pericardial mesothelioma have ever been reported.
  • Patients are diagnosed at a median age of 55.
  • The median survival time is 2-6 months.
  • As many as 80-90% of pericardial mesothelioma patients are diagnosed after death.

Pericardial Mesothelioma Causes

Pericardial mesothelioma occurs when malignant (cancerous) tumors form in the protective lining around the heart due to asbestos exposure.

Microscopic asbestos fibers are so small and strong that they can remain in the body after being breathed in or swallowed.

An illustration shows how pericardial mesothelioma forms on the protective sac-like lining of the heart known as the pericardium

Instead of being broken down or removed through coughing, the fibers irritate and inflame the tissues lining the heart. It takes 10-50 years after exposure before pericardial mesothelioma develops.

Patients with symptoms of this disease should share any asbestos exposure history with their doctors.

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Who Is at Risk for Pericardial Mesothelioma?

The following people are at risk of this cancer:

  • Female: A 2022 Seminars in Thoracic and Cardiovascular Surgery report noted that women were more likely to get this cancer.
  • Middle-aged: The average age at the time of diagnosis was 57 years, according to the 2022 Seminars in Thoracic and Cardiovascular Surgery study.

As medical professionals continue to review pericardial mesothelioma cases, more light will hopefully be shed on why these people are at risk.

Pericardial Mesothelioma Symptoms

Pericardial mesothelioma symptoms are often vague and may mimic signs of more common heart disorders. In addition, symptoms may take 10-50 years to develop after asbestos exposure.

Symptoms of pericardial mesothelioma include:

  • Chest pain
  • Cough
  • Difficulty breathing (dyspnea)
  • Fatigue
  • Fever
  • Heart murmurs
  • Irregular heartbeat (arrhythmia)
  • Night sweats
  • Shortness of breath
  • Unexplained weight loss

Most symptoms are caused by fluid buildup in the lining of the heart (pericardial effusion) or by pericardial thickening.

However, the symptoms are often subtle and easily confused with other conditions like cardiovascular disease or an irregular heartbeat.

Download our Free Symptoms Checklist to track any signs of mesothelioma and share it with your doctor so you can get an accurate diagnosis.

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Monitor your health with our easy-to-use checklist for a better chance at early diagnosis and treatment.

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Pericardial Mesothelioma Diagnosis

The following tests can help to diagnose pericardial mesothelioma. If a doctor makes a pericardial mesothelioma diagnosis before the cancer has spread, patients may have a better overall health outlook.

Imaging Scans

Doctors often use imaging scans first to detect fluid buildup around the heart and to determine if tumors are present.

Doctors may use the following imaging scans to make a pericardial mesothelioma diagnosis:

  • Computed tomography (CT) scan
  • Echocardiography
  • Magnetic resonance imaging (MRI)
  • Radionuclide imaging

While imaging tests cannot confirm a pericardial mesothelioma diagnosis, they are an important early step in the process.

If fluid buildup, pericardial thickening, or potential tumors are found on imaging scans, doctors can collect tissue or fluid samples to help officially diagnose the patient.


Biopsies are used to confirm a pericardial mesothelioma diagnosis. During a biopsy, a surgeon removes a tiny tissue sample from the pericardium. A pathologist then examines its cells under a microscope to determine if they are cancerous.

If they find mesothelioma cells in the tissue sample, they can make a final diagnosis.

Getting a Second Opinion

The symptoms of pericardial mesothelioma resemble many other conditions, and the disease is so rare that some doctors may not even consider it when making a diagnosis.

Therefore, it is crucial to get a second opinion from a mesothelioma specialist — particularly one who has experience with pericardial mesothelioma — to make sure you’ve been correctly diagnosed.

Our Free Mesothelioma Doctor Match can help you find local specialists and cancer centers who can best diagnose and treat you. Get started now.

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Pericardial Mesothelioma Stages

Doctors can often determine cancer stage at the time of diagnosis. The stage shows how far the cancer has spread through the body.

Not enough is known about pericardial mesothelioma for doctors to classify it into the typical stages of mesothelioma. Instead, pericardial mesothelioma cases are considered either advanced or localized.

Most pericardial patients are diagnosed during the advanced stage of the disease.

Pericardial Mesothelioma Prognosis

A mesothelioma prognosis describes the general course the disease takes, including a patient’s chances for recovery.

The prognosis of pericardial mesothelioma is poor, with patients having an average life expectancy of 2-6 months.

However, there are always exceptions to the average. For example, a woman with pericardial mesothelioma lived for 4 years after getting treatment, according to a study published in the Annals of Thoracic Surgery.

Factors That Affect Prognosis

Pericardial mesothelioma prognosis may be affected by:

  • Cell type
  • Patient age and overall health
  • Speed of diagnosis
  • Stage of the cancer
  • Treatment

Getting diagnosed and treated before the cancer spreads are some of the most important factors. If doctors can catch the cancer in the localized stage, it’s easier to treat and patients could live longer.

Improving Pericardial Mesothelioma Prognosis

Pericardial mesothelioma patients may be able to take certain actions to help improve their prognosis.

To improve a prognosis, patients should:

  • Get treatment: Working with experienced doctors to get treatment will give patients the best chance of living longer and with less pain.
  • Manage their stress level: High stress contributes to worse overall patient health and may harm the heart.
  • Practice healthy habits: Generally, mesothelioma patients benefit from eating well and staying as active as possible. Doing so may boost their immune systems, decrease stress, improve their overall health, and make it easier to recover from treatments.

Pericardial Mesothelioma Treatment

The main treatment methods for pericardial mesothelioma are:

  • Surgery
  • Chemotherapy
  • Radiation

Which pericardial mesothelioma treatment options are used depends on when the cancer is diagnosed.

When possible, doctors will want to use a multimodal treatment approach (using several treatments together) for best results.


Surgery is often the best way to improve the lifespan of pericardial mesothelioma patients.

Most pericardial mesothelioma patients undergo 1 of 2 surgeries:

  • Pericardiectomy: This surgery allows doctors to remove tumors and all or part of the pericardium.
  • Tumor resection: During tumor resection, surgeons remove cancerous tumors but not the pericardium.

A 2017 review published in the medical journal Herz found that patients who underwent a tumor resection lived longer than those who had a pericardiectomy.

However, if a patient has advanced pericardial mesothelioma, they may not be able to get surgery. In these cases, other treatments will be used instead.


Some patients have responded well to the chemotherapy (cancer-killing drugs).

These chemotherapy drugs can help treat pericardial mesothelioma:

  • Carboplatin
  • Cisplatin
  • Gemcitabine
  • Pemetrexed
  • Vinorelbine

Doctors will want to use two or more chemotherapy drugs together for best results. They may also use chemotherapy treatments alongside surgery.


Specialists may sometimes use radiation therapy along with chemotherapy to treat pericardial mesothelioma.

Radiation involves shooting high-intensity energy beams at the tumors to kill cancer cells.

A 2020 study from Advances in Radiation Oncology reported on a woman who received chemotherapy and radiation. She only reported minor side effects like dizziness from her treatments.

Clinical Trials and new treatments

Clinical trials allow doctors to safely study new pericardial mesothelioma treatments.

New treatments being tested in trials include:

  • Anti-angiogenesis: Scientists use special drugs to block the growth of blood vessels in cancerous tumors rather than blocking cancer cells themselves. Without enough blood, tumors can’t grow.
  • Gene therapy: Gene therapy is the process of changing, removing, or adding genes to a patient in order to fight or prevent a disease.
  • Immunotherapy: This treatment involves training the body’s own immune system to effectively target and kill mesothelioma cancer cells.
  • Photodynamic therapy: This therapy makes cancerous tissue photosensitive with a drug and then uses a laser light to kill the cancer.

These new treatment options are currently being studied in clinical trials.

Palliative Treatment

Palliative treatments can ease pain and discomfort.

Palliative treatments for pericardial mesothelioma include:

  • Chemotherapy: A low dose of chemotherapy can slow the growth of tumors and reduce symptoms.
  • Medication: A doctor may prescribe pain medication to help patients deal with their symptoms.
  • Pericardiocentesis: Here, a surgeon inserts a small catheter into the heart lining and drains fluid buildup to ease the pressure caused by pericardial effusions.
  • Pericardiectomy: Removing the lining of the heart eases inflammation, pressure, and fluid buildup.

Alternative therapies such as acupuncture, stress reduction practices, and relaxation techniques may also help patients cope with the symptoms of pericardial mesothelioma.

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Top Pericardial Mesothelioma Specialists

Working with an experienced mesothelioma doctor is critical to receiving the best care for pericardial mesothelioma.

Use our Free Mesothelioma Doctor Match to find a specialist who can assist you or a loved one.

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Pericardial mesothelioma specialists can help:

  • Diagnose you
  • Share advice on the best ways to improve prognosis
  • Perform surgeries and other treatments
  • Refer you to other specialists as needed

Since pericardial mesothelioma is so rare, it’s often not in your best interest to work with a general doctor to get treatment. You need doctors who have a lot of experience in treating this cancer.

Pericardial Mesothelioma Cancer Centers

Many mesothelioma cancer centers have doctors and medical teams on staff who can treat pericardial mesothelioma.

Pericardial mesothelioma cancer centers include:

Call (866) 608-8933 to get help finding a pericardial mesothelioma cancer center.

Cost of Pericardial Mesothelioma Treatment

The average estimated cost for mesothelioma treatment is around $500,000.

In addition, patients may have a number of unexpected costs — many of which may not be covered by insurance.

The cost of mesothelioma treatment may vary according to:

  • Caregiving needs
  • Health care providers
  • Insurance coverage
  • Lodging needs
  • Lost income
  • Travel requirements

Support Options for Pericardial Mesothelioma

There are many ways that pericardial mesothelioma patients and their families can get support and financial aid.

These include:

  • Asbestos trust funds: The U.S. government ordered bankrupt asbestos companies to contribute to trust funds. Trusts contain over $30 billion. Work with our team to get money from these funds.
  • Clinical trials: It typically costs little to nothing to get treatment through a clinical trial.
  • Private claims: Mesothelioma patients may qualify for compensation worth $1 million or more. Our team can help your family file a claim if you’re eligible.
  • U.S. Department of Veterans Affairs (VA) benefits: VA benefits to help with the costs of travel, lodging, caregiving, end-of-life care, and other needs. Veterans with mesothelioma can file for VA benefits after a diagnosis.

Learn more about treating pericardial mesothelioma and affording care in our Free Mesothelioma Guide.

Pericardial Mesothelioma FAQs

How is pericardial mesothelioma diagnosed?

Initially, doctors will likely use an imaging test to look for fluid buildup or tumors around the heart.

If the imaging tests show abnormalities, the doctor will then order a biopsy.

Biopsies are the only way to diagnose mesothelioma. 

What are the symptoms of pericardial mesothelioma?

Common symptoms of pericardial mesothelioma include chest pain, irregular heartbeat, fever, and difficulty breathing.

However, many of these symptoms could be mistaken for more common heart-related problems.

If you or a loved one worked with asbestos decades ago and now have possible symptoms, make sure to see a specialist quickly.

What is the prognosis for pericardial mesothelioma?

Pericardial mesothelioma has a poor prognosis, with patients only living a few months without treatment on average.

However, you might be able to live for many years with this cancer if you undergo aggressive treatments.

Call (866) 608-8933 to find doctors who can diagnose and treat you.

Dr. Mark LevinReviewed by:Mark Levin, MD

Certified Oncologist and Hematologist

  • Fact-Checked
  • Editor

Mark Levin, MD, has over 30 years of experience in academic and community hematology and oncology. In addition to serving as Chief or Director at four different teaching institutions throughout his life, he is still a practicing clinician, has taught and designed formal education programs, and has authored numerous publications in various fields related to hematology and oncology.

Dr. Mark Levin is an independently paid medical reviewer.

  • Board Certified Oncologist
  • 30+ Years Experience
  • Published Medical Author
Jenna TozziWritten by:

Director of Patient Advocacy

Jenna Tozzi, RN, is the Director of Patient Advocacy at Mesothelioma Hope. With more than 15 years of experience as an adult and pediatric oncology nurse navigator, Jenna provides exceptional guidance and support to mesothelioma patients and their loved ones. Jenna has been featured in Oncology Nursing News and is a member of the Academy of Oncology Nurse & Patient Navigators & the American Nurses Association.

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  1. The American Cancer Society. (2020). Survival Rates for Mesothelioma. Retrieved May 31, 2024, from
  2. American Cancer Society. (2019). Things to Know About the Cost of Your Cancer Treatment. Retrieved May 31, 2024, from
  3. Brydges, H., et al. (2021, February). Primary Pericardial Mesothelioma: A Population-Based Propensity Score-Matched Analysis. Retrieved May 31, 2024, from
  4. Feng, X., Zhao, L., Han, G., Khalil, M., Green, F., Ogilvie, T., & Krause, V. (2012). A case report of an extremely rare and aggressive tumor: primary malignant pericardial mesothelioma. Rare tumors, 4(2), e21. Retrieved Retrieved May 31, 2024, from
  5. Godar, M., Liu, J., Zhang, P., Xia, Y., & Yuan, Q. (2013). Primary Pericardial Mesothelioma: A Rare Entity. Case Reports in Oncological Medicine, 2013. Retrieved May 31, 2024, from
  6. Jodati, A., Kazemi, B., Safaei, N., & Toufan, M. (2013). A Ball in the Heart: An Interesting Discovery in a Very Rare Cardiac Tumor. Journal of cardiovascular and thoracic research, 5(2), 77–80. Retrieved May 31, 2024, from
  7. Mezei, G., Chang, E. T., Mowat, F. S., & Moolgavkar, S. H. (2017). Epidemiology of Mesothelioma of the Pericardium and Tunica Vaginalis Testis. Annals of Epidemiology, 27(5), 348-359. Retrieved May 31, 2024, from
  8. Moffitt Cancer Center. (n.d.). Types of Mesothelioma. Retrieved May 31, 2024, from
  9. Nilsson, A., & Rasmuson, T. (2009). Primary Pericardial Mesothelioma: Report of a Patient and Literature Review. Case reports in oncology, 2(2), 125–132. Retrieved May 31, 2024, from
  10. Offin, M., et al. (2022, December). Multimodality Therapy in Patients With Primary Pericardial Mesothelioma.
    Retrieved May 31, 2024, from
  11. Oliveira, G. H. et al. (2015, October 14). Characteristics and survival of malignant cardiac tumors. Circulation. Retrieved May 31, 2024, from
  12. Ramachandran, R., Radhan, P., Santosham, R., & Rajendiran, S. (2014). A rare case of primary malignant pericardial mesothelioma. Journal of clinical imaging science, 4, 47. Retrieved May 31, 2024, from
  13. Rizzardi, C., Barresi, E., Brollo, A., Cassetti, P., Schneider, M., & Melato, M. (2010). Primary Pericardial Mesothelioma in an Asbestos-exposed Patient with Previous Heart Surgery. Anticancer Research, 30(4), 1323-1325. Retrieved May 31, 2024, from
  14. Rodriguez, M., et al. (2018, May 22). Recurrence of Pericardial Mesothelioma Affecting the Myocardium After Pericardial Resection.
    Retrieved May 31, 2024, from
  15. Schaefer IM, Mariño-Enríquez A, Hammer MM, Padera RF, Sholl LM. (2023, September). Recurrent Tumor Suppressor Alterations in Primary Pericardial Mesothelioma. Retrieved May 31, 2024, from
  16. Steber, C., et al. (2020, September 22). Malignant Pericardial Mesothelioma Treated Using Volumetric Modulated Arc Therapy With a Simultaneous Integrated Boost. Retrieved May 31, 2024, from
  17. Sardar, M. R., Kuntz, C., Patel, T., Saeed, W., Gnall, E., Imaizumi, S., & Lande, L. (2012). Primary pericardial mesothelioma unique case and literature review. Texas Heart Institute journal. Retrieved May 31, 2024, from
  18. UT Southwestern Medical Center. (n.d.). Pericardial Cancer. Retrieved May 31, 2024, from
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