Pericardial mesothelioma is a cancer in the thin lining of tissue that surrounds the heart, called the pericardium. The cancer can occur at any age, and has a mean age of 46 years at presentation. Mesothelioma symptoms include chest pain, dyspnea, cough, and palpitations. Although there appears to be a strong link to asbestos exposure, a definite association has not been established due to the rarity of this lesion. Surgery combined with radiation therapy may provide some palliation, but the prognosis is extremely poor.   Pericardial mesothelioma is the least common form of malignant mesothelioma. It only accounts for 5 to 15% of all cases.