Malignant mesothelioma of the pleura with extensive cardiac invasion and tricuspid orifice occlusion.

Malignant mesotheliomas of the pleura generally cause death by progressive encasement of the lung, but characteristically do not form large tumor masses or deeply invade the lung. Symptoms of pericardial involvement may be present in about 9% of patients at presentation, but at autopsy up to 67% are alleged to extension of the tumor to the pericardium. Infiltration of the myocardium occurs less frequently, but the exact frequency is unknown, and the extent of invasion and clinical effects are poorly documented. The authors report a case of a malignant mesothelioma of the pleura, which extended to involve the pericardium, necessitating pericardiectomy. Subsequently, the patient died as a result of tumor growth through the right atrial wall forming a large intraatrial mass that occluded the tricuspid orifice.