scholarly journals Cardiac tamponade due to malignant pericardial effusion in breast cancer: A case report

2016 ◽  
Vol 9 (1) ◽  
pp. 53
Author(s):  
Sultan Mahmud ◽  
Omar Sadeque Khan ◽  
Md. Aftabuddin ◽  
Asit Baran Adhikary
Keyword(s):  
Breast Cancer ◽  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Duct Cell ◽  
Pericardial Fluid ◽  
Pericardial Window ◽  
Severe Respiratory Distress ◽  
Malignant Pericardial Effusion ◽  
History Of ◽  
Subxiphoid Pericardial Window

We present a case of 35 years old women who presented to our institution with a history of bilateral infiltrating duct cell carcinoma of breast, chest pain with heaviness, severe respiratory distress and hypotension. Echocardiography revealed massive pericardial effusion with features of cardiac tamponade. The patient was treated with urgent pericardiocentesis followed by subxiphoid pericardial window drainage of 500ml of haemorrhagic pericardial fluid. Cytological examina­tion confirmed the previous suspicious of malignancy. The patient tolerated the procedure very well, immediate sympto­matic relief was observed.

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.

scholarly journals Malignant pericardial effusion complicated by cardiac tamponade under atezolizumab

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110360
Author(s):  
Lardinois Benjamin ◽  
Goeminne Jean-Charles ◽  
Miller Laurence ◽  
Randazzo Adrien ◽  
Laurent Terry ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Cardiac Toxicity ◽  
Checkpoint Inhibitors ◽  
Final Diagnosis ◽  
Pericardial Fluid ◽  
Malignant Pericardial Effusion ◽  
Typical Cell ◽  
High Fluorescence ◽  
Tomography Scan

Immune-related adverse events including cardiac toxicity are increasingly described in patients receiving immune checkpoint inhibitors. We described a malignant pericardial effusion complicated by a cardiac tamponade in an advanced non-small cell lung cancer patient who had received five infusions of atezolizumab, a PDL-1 monoclonal antibody, in combination with cabozantinib. The definitive diagnosis was quickly made by cytology examination showing typical cell abnormalities and high fluorescence cell information provided by the hematology analyzer. The administration of atezolizumab and cabozantinib was temporarily discontinued due to cardiogenic hepatic failure following cardiac tamponade. After the re-initiation of the treatment, pericardial effusion relapsed. In this patient, the analysis of the pericardial fluid led to the final diagnosis of pericardial tumor progression. This was afterwards confirmed by the finding of proliferating intrapericardial tissue by computed tomography scan and ultrasound. This report emphasizes the value of cytology analysis performed in a hematology laboratory as an accurate and immediate tool for malignancy detection in pericardial effusions.

Malignant pericardial effusion with cardiac tamponade in a patient with metastatic vaginal adenocarcinoma

2006 ◽  
Vol 16 (3) ◽  
pp. 1458-1461 ◽  
Author(s):  
N. P. Nagarsheth ◽  
M. Harrison ◽  
T. Kalir ◽  
J. Rahaman
Keyword(s):  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Lung Metastases ◽  
Gynecological Cancer ◽  
Disease Process ◽  
Surgical Excision ◽  
Clear Cell Adenocarcinoma ◽  
Pericardial Window ◽  
Malignant Pericardial Effusion ◽  
Platinum Based Chemotherapy

Malignant pericardial effusion with cardiac tamponade is a rare manifestation of metastatic gynecological cancer. A 35-year-old female was diagnosed with clear cell adenocarcinoma of the vagina. Four years after partial vaginectomy, she developed regional recurrence and was treated with surgical excision followed by platinum-based chemotherapy and radiation therapy. Six years later, the patient was diagnosed with lung metastases and received a combination adriamycin and platinum-based chemotherapy. Shortly after completing treatment, she presented with weakness and was found to be hypotensive on physical exam. Computed tomography scan confirmed a pericardial effusion with evidence of bilateral heart failure. She underwent an emergent pericardiocentesis and eventual pericardial window procedure. Metastatic adenocarcinoma of the vagina can present with malignant pericardial effusion with cardiac tamponade. Therefore, gynecologists and gynecological oncologists need to be familiar with the diagnosis and management of this disease process.

Intrapericardial tetracycline sclerosis in the treatment of malignant pericardial effusion: an analysis of thirty-three cases.

1984 ◽  
Vol 2 (6) ◽  
pp. 631-636 ◽  
Author(s):  
S Davis ◽  
P Rambotti ◽  
F Grignani
Keyword(s):  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Performance Status ◽  
Signs And Symptoms ◽  
Pericardial Fluid ◽  
Complete Control ◽  
Malignant Pericardial Effusion ◽  
Efficacious Treatment ◽  
Clinically Significant ◽  
Premature Removal

Thirty-three unselected patients with cardiac tamponade secondary to malignant pericardial effusion were treated by intrapericardial instillation of tetracycline hydrochloride. Complete control of the initial signs and symptoms of tamponade was obtained in 30 patients without concomitant chemotherapy or radiotherapy. The procedure did not result in clinically significant complications. Failure of the technique was related to premature removal of the catheter by the patient (one patient) or the inability to totally remove hemorrhagic, clot-filled pericardial fluid (two patients). Survival ranged between 28-704 days and extended survival was related to the performance status and/or chemoradiosensitivity of the primary cancer. No patient successfully treated subsequently developed recurrent cardiac tamponade or alternatively, constrictive pericarditis. Tetracycline pericardial instillation remains a safe, simple, and efficacious treatment of tamponade secondary to malignant disease.

scholarly journals Cardiac Tamponade due to Malignant Pericardial Effusion in 3 Patients with Breast Cancer.

2002 ◽  
Vol 63 (7) ◽  
pp. 1658-1661
Author(s):  
Natsuko UE ◽  
Hidetaka KAWABATA ◽  
Takafumi UENO ◽  
Masaru HIRATA ◽  
Kiyoshi TANAKA
Keyword(s):  
Breast Cancer ◽  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Malignant Pericardial Effusion

scholarly journals A Rare Presentation of Cardiac Tamponade from Metastatic Urothelial Carcinoma of the Bladder

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Sowmya Palam ◽  
Ridhima Kapoor ◽  
Jacquelyn Kulinski
Keyword(s):  
Urothelial Carcinoma ◽  
Cardiac Tamponade ◽  
English Literature ◽  
Pericardial Fluid ◽  
High Grade ◽  
Rare Presentation ◽  
Pericardial Window ◽  
Cardiac Metastases ◽  
History Of ◽  
Carcinoma Of The Bladder

A 62-year-old man presented with 2 weeks of progressive dyspnea and chest pain. He was previously diagnosed with high-grade invasive urothelial carcinoma (UC) of the bladder and underwent neoadjuvant chemotherapy followed by radical cystectomy 10 months earlier, resulting in pathologic complete remission. Clinical evaluation and echocardiographic imaging was consistent with a diagnosis of cardiac tamponade. Due to a history of malignancy, the patient was referred for a surgical pericardial window, to include biopsy of the pericardium. Pericardial fluid and pericardial biopsy specimens were consistent with metastatic UC. Cardiac tamponade due to metastatic UC is a rare presentation, and, to our knowledge, there have been only 5 cases reported in the English literature. We report a rare case of cardiac tamponade due to isolated pericardial metastases from high grade UC of the bladder and discuss the symptoms, treatment, and prognosis of this pathologic condition. We also present a brief review of previously published literature. Through this discussion, we would like to emphasize the (1) consideration of cardiac metastases in the differential diagnosis for patients with a history of UC presenting with cardiac or pulmonary symptoms and (2) improved diagnostics with pericardial biopsy and pericardiocentesis over pericardiocentesis alone.

1101 Multimodality imaging in the assessment of pericardial malign disease

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M Codina ◽  
G Ramirez-Escudero Ugalde ◽  
A Manzanal Rey ◽  
N Garcia Ibarrondo ◽  
S Cisneros Carpio ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Multimodality Imaging ◽  
Stage Iv ◽  
Pericardial Fluid ◽  
Fluid Composition ◽  
Blood Oxygen Saturation ◽  
Pericardial Window ◽  
Malignant Pericardial Effusion ◽  
Multiple Metastases ◽  
Poor Tolerance

Abstract Metastases to the heart and pericardium are discovered at autopsy in 10%–12% of all patients with malignancies. The most common primary tumor involving the pericardium is lung cancer, followed by breast, melanoma, and lymphoma. Pericardial effusion may be the result of the tumor spreading to the visceral pericardium which increases production of fluid, or accumulation of the fluid due to the obstruction of venous and lymphatic outflow. A malignant pericardial effusion is associated with decreased survival rate. We present a 72 year-old woman, former smoker with dyslipidemia and psoriatic arthritis as well as previous bladder carcinoma that was healed in 1986. On august 2017 after an acute intestinal obstruction she was diagnosed with stage IV ileum adenocarcinoma treated initially with palliative chemotherapy (Capecitabine and oxaliplatin) that was suspended for poor tolerance and according to patient desire. Few months later the patient complained of rapidly progressive dyspnoea that prevented her normal life activity, arterial pressure and blood oxygen saturation was normal, but she was tachycardic. Echocardiogram was performed (see figure) which showed marked pericardial nodular thickening and severe pericardial effusion with echocardiographic signs of cardiac tamponade. Curiously, pericardial effusion was dense and markedly hyperechogenic. A computed tomography (CT) was performed to rule out pericardial carcinomatosis and find out the pericardial fluid composition and demostrated several pericardial nodular thickenings that suggested metastases. The pericardial fluid was dense (40 hounsfield units) and consistent with blood. After multidispiplinar consultation and in accordance with patients wishes a palliative pericardial window was performed and hematic pericardial fluid was obtained. Pericardial liquid citology demonstrates atipical cells compatible with carcinoma and pericardial biospy showed fibrinous pericarditis and reactive mesothelial hyperplasia. Pericardial carcinomatosis consists of macroscopic or microscopic affection of pericardial layers. Metastasis from colorectal cancer to the pericardium is uncommon, and usually indicates terminal stage with multiple metastases, only a few cases have been reported. Malignant Pericardial effusions in patients with cancer may also be triggered by other mechanism than cancer itself, including chemotherapy, radiation therapy, and, less commonly, an infectious disease. Whereas echocardiography is most frequently used to examine the heart and pericardium, multimodaliy imaging with magnetic resonance (MR) or/and CT offer advantages when dealing with metastatic disease. Abstract 1101 Figure. Echocardiogram and CT images

scholarly journals Survival post surgery for malignant pericardial effusion

2011 ◽  
Vol 1 (2) ◽  
pp. 38 ◽  
Author(s):  
Olivier Nguyen ◽  
Denise Ouellette
Keyword(s):  
Lung Cancer ◽  
Pericardial Effusion ◽  
Survival Rates ◽  
Primary Lung Cancer ◽  
Pericardial Window ◽  
Term Survival ◽  
Advanced Malignancy ◽  
Malignant Pericardial Effusion ◽  
Post Surgery ◽  
Subxiphoid Pericardial Window

The study reviews the survival of patients with malignant pericardial effusion treated with a subxiphoid pericardial window. The medical records of 60 consecutive patients diagnosed with a malignant pericardial effusion and treated with a subxiphoid pericardial window between 1994 and 2008 were reviewed. 72% had lung cancer. Overall 30-day mortality was 31%. Survival rates at 3 months, 6 months, 1 year, and 2 years were 45%, 28%, 17%, and 9%, respectively. Overall median survival was 2.6 months. Patients with malignant pericardial effusion, especially those with primary lung cancer have poor survival rates. In advanced malignancy, the subxiphoid pericardial window procedure provides only short-term palliation of symptoms, and has no effect on long-term survival. The use of any surgical procedure in patients with malignant advanced pericardial effusion should be considered along with nonsurgical options on a case-by-case basis depending on symptoms, general status, and expected survival.

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