scholarly journals Pericardial Tamponade and Elevated Serum CA-125 Level in Inadequately Treated Hypothyroidism

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Moaaz Baghal ◽  
Viralkumar Amrutiya ◽  
Bhoomi Patel ◽  
Rutwik Patel ◽  
Jonathan Hernandez ◽  
...  
Keyword(s):  
Cardiac Tamponade ◽  
Elevated Serum ◽  
Abdominal Distension ◽  
Young Female ◽  
Pericardial Tamponade ◽  
Medical Emergency ◽  
Ca 125 ◽  
Pericardial Window ◽  
Abdominal Paracentesis ◽  
Shed Light

Cardiac tamponade is a medical emergency and must be managed promptly, and reaching a diagnosis is imperative to prevent recurrence. Herein, we present a case of a young female patient that presented with progressive shortness of breath and abdominal distension and was found to have cardiac tamponade with the finding of elevation of a blood tumor marker, CA-125, in the setting of nonadherence to thyroid replacement therapy. She was managed by surgical pericardial window and abdominal paracentesis, with replacement of thyroid hormones leading to resolution of the tamponade and ascites. CA-125 elevation associated with cardiac tamponade and myxedema ascites due to hypothyroidism is very rare, and we aim to shed light on the importance of having a broad differential when approaching cardiac tamponade and understand the association between CA-125 and hypothyroidism.

Cardiac Tamponade - A Hypothyroidism Associated Emergency: A Report of 2 Cases

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Tripathi S ◽  
◽  
Sharma JB ◽  
Vijayvergia P ◽  
Khichar S ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Young Female ◽  
Medical Emergency ◽  
Myxedema Coma ◽  
First Case ◽  
History Of ◽  
Medical Emergencies ◽  
Recurrent Pericardial Effusion

Pericardial effusion in commonly seen in-patient with hypothyroidism but effusion large enough to cause cardiac tamponade is not a common presenting feature whereas myxedema coma is a commonly defined medical emergency in-patient with hypothyroidism. We report 2 cases of hypothyroid associated medical emergencies. First case is a young female with history of recurrent pericardial effusion presenting to the emergency department with cardiac tamponade and later on diagnosed as having hypothyroidism. The second patient is a known case of hypothyroidism non-compliant to thyroid supplement and presented with lethargy, fatigue, decreased talking and breathlessness who was later diagnosed as having myxedema coma and impending cardiac tamponade. Both the patient required percutaneous pericardiocentesis and improved with medical management.

scholarly journals Sclerosing sex cord stromal tumour of the ovary: A rare variant of ovarian neoplasms in childhood and adolescence

2016 ◽  
Author(s):  
Seema Chopra
Keyword(s):  
Ovarian Neoplasms ◽  
Elevated Serum ◽  
Abdominal Distension ◽  
Stromal Tumour ◽  
Ca 125 ◽  
Childhood And Adolescence ◽  
Menstrual Cycles ◽  
Sclerosing Stromal Tumor ◽  
Loss Of Appetite ◽  
Unmarried Girl

Case Report: 19 yr old unmarried girl c/o abdominal distension, loss of appetite and Irregular menstrual cycles x 5 months. USG: gross ascites, liver, Lobulated isoechoic mass in right adnexa, 7x5 cm, abutting right ovary. CA125: 1297 U/ml. FNAC Degenerated crushed cells & stromal fragments. Few scattered benign oval/spindle cells. Laparoscopy f/b laparotomy: 6 litres of straw colored asciic fluid drained. Uterus, left adnexa normal. Rt ovarian mass 6x7 cm, bilobed, arising from ovary. Solid, stuck in POD Adherent to gut. Right oophrectomy done. CA-125: 22 u/ml on day 6 post op. HPE – Sclerosing stromal tumor. Discussion: Sclerosing sex cord stromal tumour of the ovary is a rare tumor; accounts for 6% of ovarian stromal tumors Over a 100 reported tumors in literature. 80% of SST seen in second and third decade of life. Essentially a benign tumour, Usually a unilateral nonfunctioning tumor. Few cases with elevated serum CA-125 and hormonal abnormalities have been reported. Endocrine alterations caused by secretion of estrogen, progesterone or testosterone; induction of precocious puberty. Conclusion: Unilateral oophrectomy is the treatment. No recurrence of the tumor in the patients treated by oophorectomy or by conservative resection of the tumor. Excision of the tumor isfollowed by normal menses, pregnancy has also been reported.

A Case of Biventricular Failure after Pericardial Window for Large Pericardial Effusion

2015 ◽  
Vol 18 (1) ◽  
pp. 036 ◽  
Author(s):  
Michael M. Koerner ◽  
Mahboob Alam ◽  
Aly El-Banayosy ◽  
Arunima Misra ◽  
Matthew J. Wall, Jr ◽  
...  
Keyword(s):  
Cardiac Tamponade ◽  
Case Reports ◽  
Systolic Dysfunction ◽  
Case Series ◽  
Pericardial Tamponade ◽  
Pericardial Window ◽  
Hemodynamic Compromise ◽  
Large Pericardial Effusion ◽  
Biventricular Failure ◽  
Large Case Series

Pericardial tamponade resulting in hemodynamic compromise requiring either pericardiocentesis [Vandyke 1983] or subxiphoid pericardial window has been reported in literature [Armstrong 1984]. There are no large case series, only scattered case reports. Cardiac tamponade is known to affect the diastolic function of the heart but rare reports have documented systolic impairment of the left and right ventricle in the setting of tamponade [Vandyke 1983; Armstrong 1984]. We report a case of a transient biventricular systolic dysfunction in a patient with early cardiac tamponade after surgical drainage of pericardia1 effusion.

scholarly journals Bilateral Serous Psammocarcinoma of Ovary: Rare Variant Low Grade Serous Carcinoma

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Saubhagya Kumar Jena ◽  
Pritinanda Mishra ◽  
Vandana Mohapatra ◽  
Sweta Singh
Keyword(s):  
Rare Variant ◽  
Elevated Serum ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Serous Carcinoma ◽  
Ca 125 ◽  
Low Grade ◽  
Primary Debulking Surgery ◽  
Stage Disease ◽  
Enhanced Computed Tomography

Serous psammocarcinoma is a rare variant of serous carcinoma arising from either ovary or peritoneum, characterized by massive psammoma body formation, low grade cytologic features, and invasiveness. Its clinical behavior is similar to serous borderline tumors with relatively favorable prognosis. We report herein a case of a 60-year-old postmenopausal woman who presented with abdominal distension. Contrast enhanced computed tomography (CECT) revealed calcified pelvic masses with ascites. Elevated serum CA-125 (970 U/mL) suggested malignant ovarian neoplasm. Patient underwent exploratory laparotomy with primary debulking surgery. Histopathology showed bilateral serous psammocarcinoma of ovary with invasive implants on omentum. Adjuvant chemotherapy was advised in view of advanced stage disease, although its benefits are poorly defined due to rarity of the tumor. However, patient opted out of it and is now on follow-up.

Peritoneal tuberculosis with pelvic abdominal mass, ascites and elevated CA 125 mimicking advanced ovarian carcinoma: A series of 10 cases

2001 ◽  
Vol 11 (4) ◽  
pp. 290-294 ◽  
Author(s):  
T. Bilgin ◽  
A. Karabay ◽  
E. Dolar ◽  
O. H. Develioğlu
Keyword(s):  
Ovarian Cancer ◽  
Ovarian Carcinoma ◽  
Abdominal Mass ◽  
Gynecologic Cancer ◽  
Elevated Serum ◽  
Advanced Ovarian Cancer ◽  
Ca 125 ◽  
Peritoneal Tuberculosis ◽  
Advanced Ovarian Carcinoma ◽  
Abdominal Paracentesis

Abstract.Bilgin T, Karabay A, Dolar E, Develioğlu OH. Peritoneal tuberculosis with pelvic abdominal mass, ascites, and elevated CA 125 mimicking advanced ovarian carcinoma.Ten patients with peritoneal tuberculosis who were operated on for suspected advanced ovarian cancer during a 5-year period were analyzed. These 10 cases constituted 1.4% of the 728 new gynecologic cancer cases diagnosed and treated at our department during the same time period. Data were obtained from patients' files and pathology reports. The mean age of cases was 40.6 ± 6.1 (median 37; range 18–72). Ascites was present together with ill-defined nodularities or thickening in the Douglas pouch and/or in the adnexal areas on pelvic examination in all patients but three, who presented with well-demarcated adnexal masses of about 5 cm in diameter. All patients had elevated serum CA 125 levels with a median of 331 U/ml, (40–560 U/ml). Ultrasound and abdominopelvic CT examinations revealed omental and mesenteric thickening in addition to ascites in all patients, cystic ovarian masses or ovarian enlargement in five, and peritoneal implants in two. Abdominal paracentesis performed in the six cases in whom the findings were felt to be most inconclusive for the diagnosis of ovarian cancer revealed clear exudative fluid with benign cells. Mycobacteria could not be demonstrated on direct preparations. Tuberculosis was diagnosed at laparotomy in all. Patients received antituberculous therapy and serum CA 125 levels returned to normal within 2 months after the beginning of treatment. This case series demonstrates a high rate of misdiagnosis between advanced ovarian cancer and peritoneal tuberculosis. Whereas abdominal paracentesis is useless in ruling out peritoneal tuberculosis, and serum CA 125 levels are not helpful in the differential diagnosis, the latter marker may be useful in the follow-up of patients.

scholarly journals Fictitious pseudo Meig’s syndrome: A medical emergency

2012 ◽  
Vol 7 (1) ◽  
pp. 57-64 ◽  
Author(s):  
S Shukla ◽  
N Acharya ◽  
S Acharya ◽  
DP Rajput ◽  
S Vagha
Keyword(s):  
Elevated Serum ◽  
Clinical Work ◽  
Medical Emergency ◽  
Ca 125 ◽  
Free Fluid ◽  
Case Scenario ◽  
Peritoneal Adhesions ◽  
Granulomatous Lesions ◽  
Work Up ◽  
Firm Mass

The present case scenario deals with an acute on chronic symptomatology, and collapsed state of the patient with poor vitals on admission in casualty. Clinical work up pointing to an elevated serum CA 125 levels and USG pelvis suggesting peritoneal adhesions with cystic to firm mass in left ovary and minimal free fluid in abdomen and cul de sac, X Ray chest suggesting right sided Pleural effusion. It was after careful evaluation of the case, with past and present history along with signs, symptommatology and intraoperative findings that differentials like Chronic granulomatous lesions, endometriosis, Neoplastic lesions with metastasis and Meig’s syndrome or Pseudo Meig’s were evaluated. Finally, a diagnosis of genital tuberculosis with enodmetriosis was confirmed on histopathological evaluation. DOI: http://dx.doi.org/10.3126/jcmsn.v7i1.5975 JCMSN 2011; 7(1): 57-64

The Diagnostic Value of Pericardial Fluid and Pericardial Biopsy: Single Center Experiences

2016 ◽  
Vol 19 (1) ◽  
pp. 023 ◽  
Author(s):  
Mehmet Yildirim ◽  
Recep Ustaalioglu ◽  
Murat Erkan ◽  
Bala Basak Oven Ustaalioglu ◽  
Hatice Demirbag ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Thoracoscopic Surgery ◽  
Pericardial Tamponade ◽  
Pericardial Fluid ◽  
Pathological Examination ◽  
Common Disease ◽  
Pericardial Window ◽  
Surgical Interventions ◽  
History Of ◽  
Recurrent Pericardial Effusion

<strong>Background:</strong> Patients with recurrent pericardial effusion and pericardial tamponade are usually treated in thoracic surgery clinics by VATS (video-assisted thoracoscopic surgery) or open pericardial window operation. The diagnostic importance of pathological evaluation of the pericardial fluid and tissue in the same patients has been reported in few studies. We reviewed pathological examination of the pericardial tissue and fluid specimens and the effect on the clinical treatment in our clinic, and compared the results with the literature. <br /><strong>Methods:</strong> We retrospectively analyzed 174 patients who underwent pericardial window operation due to pericardial tamponade or recurrent pericardial effusion. For all patients both the results of the pericardial fluid and pericardial biopsy specimen were evaluated. Clinicopathological factors were analyzed by using descriptive analysis. <br /><strong>Results:</strong> Median age was 61 (range, 20-94 years). The most common benign diagnosis was chronic inflammation (94 patients) by pericardial biopsy. History of malignancy was present in 28 patients (16.1%) and the most common disease was lung cancer (14 patients). A total of 24 patients (13.8%) could be diagnosed as having malignancy by pericardial fluid or pericardial biopsy examination. The malignancy was recognized for 12 patients who had a history of cancer; 9 of 12 with pericardial biopsy, 7 diagnosed by pericardial fluid. Twelve of 156 patients were recognized as having underlying malignancy by pericardial biopsy (n = 9) or fluid examination (n = 10), without known malignancy previously. <br /><strong>Conclusion:</strong> Recurrent pericardial effusion/pericardial tamponade are entities frequently diagnosed, and surgical interventions may be needed either for diagnosis and/or treatment, but specific etiology can rarely be obtained in spite of pathological examination of either pericardial tissue or fluid. For increasing the probability of a specific diagnosis both the pericardial fluid and the pericardial tissues have to be sent for pathologic examination.

Acute pericardial tamponade: The initial manifestation of systemic lupus erythematosus with Graves’ hyperthyroidism

Lupus ◽  
2021 ◽  
pp. 096120332110047
Author(s):  
Muming Yu ◽  
Yulei Gao ◽  
Heng Jin ◽  
Songtao Shou
Keyword(s):  
Myocardial Infarction ◽  
Systemic Lupus Erythematosus ◽  
Female Patient ◽  
Lupus Erythematosus ◽  
Pericardial Tamponade ◽  
Medical Emergency ◽  
Systemic Lupus ◽  
Initial Manifestation ◽  
Life Threatening ◽  
Obstructive Shock

Acute pericardial tamponade, which can cause obstructive shock, is a serious life-threatening medical emergency that can be readily reversed by timely identification and appropriate intervention. Acute pericardial tamponade can occur for a number of reasons, including idiopathic, malignancy, uremia, iatrogenic, post-myocardial infarction, infection, collagen vascular, hypothyroidism, and others. Systemic lupus erythematosus (SLE) and hyperthyroidism associated with pericardial tamponade are rarely reported. Here, we report the case of a 20-year-old female patient was final diagnosed of SLE with Graves’ hyperthyroidism.

scholarly journals Primary squamous cell carcinoma of the pancreas with a large pseudocyst of the pancreas as the first manifestation: a rare case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xia Qiu ◽  
Yajie Meng ◽  
Meiqin Lu ◽  
Chuan Tian ◽  
Min Wang ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cell Mass ◽  
Elevated Serum ◽  
Abdominal Distension ◽  
Needle Aspiration ◽  
Pancreatic Pseudocysts ◽  
Primary Squamous Cell Carcinoma ◽  
Ki 67

Abstract Background Primary squamous cell carcinoma (SCC) of the pancreas with pseudocysts, especially diagnosed by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), is extremely rare. Case presentation A 64-year-old man was admitted to our department for abdominal distension. Two months ago, he experienced abdominal pain for 1 day and was diagnosed with acute pancreatitis in another hospital. After admission, laboratory tests showed the following: amylase 400 U/L, lipase 403 U/L, and carbohydrate antigen 19–9 (CA19-9) 347 U/mL. Abdominal computed tomography (CT) revealed pancreatitis with a pseudocyst with a diameter measuring 7 cm. During linear EUS, a large pseudocyst (5.4 × 5.2 cm) was observed in the pancreatic body. EUS-FNA was performed. We obtained specimens for histopathology and placed a plastic stent through the pancreas and stomach to drain the pseudocyst. Puncture fluid examination revealed the following: CA19-9 > 12,000 U/mL carcinoembryonic antigen (CEA) 7097.42 ng/ml, amylase 27,145.3 U/L, and lipase > 6000 U/L. Cytopathology revealed an abnormal cell mass, and cancer was suspected. Furthermore, with the result of immunohistochemistry on cell mass (CK ( +), P40 ( +), p63 ( +), CK7 (−) and Ki-67 (30%)), the patient was examined as squamous cell carcinoma (SCC). However, the patient refused surgery, radiotherapy and chemotherapy. After drainage, the cyst shrank, but the patient died 3 months after diagnosis due to liver metastasis and multiple organ failure. Conclusion For patients with primary pancreatic pseudocysts with elevated serum CEA and CA19-9 levels, we should not rule out pancreatic cancer, which may also be a manifestation of primary pancreatic SCC. EUS-FNA is helpful for obtaining histopathology and cytology and thus improving diagnostic accuracy.

scholarly journals Pericardial effusion and cardiac tamponade requiring pericardial window in an otherwise healthy 30-year-old patient with COVID-19: a case report

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Christina Walker ◽  
Vincent Peyko ◽  
Charles Farrell ◽  
Jeanine Awad-Spirtos ◽  
Matthew Adamo ◽  
...  
Keyword(s):  
Case Report ◽  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Case Reports ◽  
Healthy Woman ◽  
Signs And Symptoms ◽  
Rare Presentation ◽  
Pericardial Window ◽  
Acute Pericarditis ◽  
Novel Coronavirus

Abstract Background This case report demonstrates pericardial effusion, acute pericarditis, and cardiac tamponade in an otherwise healthy woman who had a positive test result for coronavirus disease 2019. Few case reports have been documented on patients with this presentation, and it is important to share novel presentations of the disease as they are discovered. Case presentation A Caucasian patient with coronavirus disease 2019 returned to the emergency department of our hospital 2 days after her initial visit with worsening chest pain and shortness of breath. Imaging revealed new pericardial effusion since the previous visit. The patient became hypotensive, was taken for pericardial window for cardiac tamponade with a drain placed, and was treated for acute pericarditis. Conclusion Much is still unknown about the implications of coronavirus disease 2019. With the novel coronavirus disease 2019 pandemic, research is still in process, and we are slowly learning about new signs and symptoms of the disease. This case report documents a lesser-known presentation of a patient with coronavirus disease 2019 and will help to further understanding of a rare presentation.

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