Primary Pericardial Mesothelioma: A Rare and Aggressive Malignancy - Case Report and Literature Review.

Primary tumors of the pericardium are exceptionally rare, with primary pericardial mesothelioma (PPM) being the most frequently encountered histological subtype. PPM is an aggressive malignancy with a poor prognosis and a median survival of approximately six months from symptom onset. Due to its nonspecific clinical presentation, diagnosis is often delayed and typically occurs at an advanced stage. We report the case of a 47-year-old woman who presented with recurrent hemorrhagic pericardial effusions and signs of hemodynamic compromise. Histopathological analysis of the resected pericardium confirmed a diagnosis of biphasic pericardial mesothelioma, predominantly epithelioid in subtype. This case highlights the diagnostic challenges and poor outcomes associated with PPM, underscoring the need for heightened clinical suspicion, timely intervention, and further research into effective management strategies.