The Case Report of Malignant Pericardial Effusion in Recurrent Endometrial Cancer: An Emergency Treatable Condition

Malignant-related pericardial effusion from endometrial cancer is a considerably rare condition. Massive fluid accumulation can cause a cardiac tamponade, which could lead to a life threatening condition. Here, the author presented a case of 45-year-old woman diagnosed of stage IIIC2 endometrial cancer, with para-aortic lymph nodes metastases. Fourteen months after completion of systemic chemotherapy and adjuvant sequential radiotherapy, she had been suffering from acute shortness of breath, tachypnea, tachycardia, and hemodynamic instability. Massive pericardial effusion was confirmed by echocardiogram. Malignant tumor cells were found on the cytological analysis. Beside pericardial effusion, computed tomography scan also demonstrated pleural effusion and multiple enlarged para-aortic lymph nodes. Pericardial window was done on the second day of admission after the diagnosis was confirmed by pericardiocentesis. Six courses of systemic chemotherapy, carboplatin and paclitaxel, were administered, followed by hormonal therapy. The patient was scheduled for follow up, every month, for 10 consecutive times. Her physical performance was in good condition without any clinical potential recurrence. Pericardial window is a palliative surgical treatment in emergency circumstance and systemic chemotherapy should be considered with clinical response result. Keywords: Malignant pericardial effusion, Endometrial cancer, Treatment

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QS7. Using Apache® III-J to Predict Outcome in Patients Undergoing Pericardial Window for Malignant Pericardial Effusion

Journal of Surgical Research ◽

10.1016/j.jss.2007.12.244 ◽

2008 ◽

Vol 144 (2) ◽

pp. 273

Author(s):

Faiz Y. Bhora ◽

Daniel Sagalovich ◽

M. Jawad Latif ◽

John Afthinos ◽

Cliff P. Connery

Keyword(s):

Pericardial Effusion ◽

Pericardial Window ◽

Malignant Pericardial Effusion

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

International Journal of Gynecological Cancer ◽

10.1136/ijgc-00009577-200605000-00081 ◽

2006 ◽

Vol 16 (3) ◽

pp. 1458-1461 ◽

Cited By ~ 2

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.

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Subxiphoid window drainage of pericardial effusion - study of 35 cases

University Heart Journal ◽

10.3329/uhj.v5i2.4558 ◽

1970 ◽

Vol 5 (2) ◽

pp. 71-74 ◽

Cited By ~ 1

Author(s):

Rezwanul Hoque ◽

Mostafa Nuruzzaman ◽

Sabrina Sharmin Husain ◽

Zerzina Rahman

Keyword(s):

Pericardial Effusion ◽

Thoracoscopic Surgery ◽

Exclusion Criteria ◽

Pericardial Window ◽

Echocardiographic Finding ◽

Malignant Pericardial Effusion ◽

Physical Findings ◽

Age Range ◽

Effusive Constrictive Pericarditis ◽

Video Assisted Thoracoscopic Surgery

Pericardial effusion defines the presence of an abnormal amount and/or character of fluid in the pericardial space. It can be acute or chronic and caused by a variety of local and systemic disorders, or it may be idiopathic. Pericardial effusion can be relieved by medical treatment, pericardiocentesis through a needle with or without echocardiographic guidance, or by surgical procedures, such as subxiphoid pericardial tube drainage, by creating a pericardial window through a left anterior thoracotomy, or by video assisted thoracoscopic surgery (VATS) Subxiphoid pericardial window drainages were done on 35 patients with symptomatic pericardial effusion in the Department of cardiac surgery, BSMMU, from February, 1995 through July, 2009, and were all included in this retrospective observational study. The inclusion criteria were an established diagnosis of pericardial effusion confirmed by history, physical findings and transthoracic echocardiography, hemodynamic alteration as evidenced by hypotension( systolic blood pressure < 90 mm of Hg), shortness of breath, echocardiographic finding of > 10 mm echo free space with/ without compression of heart, recurrence after pericardiocentesis, haemorrhagic or thick pericardial effusion and malignant pericardial effusion. The exclusion criteria were loculated or post surgical pericardial effusion, effusive constrictive pericarditis or where formal thoracotomy was applied for drainage of effusion. Patients were followed up at one month and three months following the drainage procedure. The age range was from 13 years to 70 years (Mean 47.86 ± SD 15.20 years), 19 (54.28%) were male, 16(45.72%) were female. The symptomatology varied but cardiac and respiratory decompression overwhelmed other symptoms. In this study tuberculosis is the most common cause of pericardial effusion, idiopathic and malignancies are other important causes. Subxiphoid window drainage is an effective process in relieving pericardial effusion and the reaccumulation rate is low. Key words: Subxiphoid window drainage; Surgical drainage of pericardial effusion; Pericardial effusion. DOI: 10.3329/uhj.v5i2.4558 University Heart Journal Vol.5(2) July 2009 pp.71-74

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

Bangabandhu Sheikh Mujib Medical University Journal ◽

10.3329/bsmmuj.v9i1.28946 ◽

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.

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Subxiphoidal pericardial ‘window’ in the management of malignant pericardial effusion

European Journal of Surgical Oncology ◽

10.1016/s0748-7983(95)97268-4 ◽

1995 ◽

Vol 21 (5) ◽

pp. 545-547 ◽

Cited By ~ 3

Author(s):

P.P. Vassilopoulos ◽

K. Nikolaidis ◽

E. Filopoulos ◽

J. Griniatsos ◽

A. Efremidou

Keyword(s):

Pericardial Effusion ◽

Pericardial Window ◽

Malignant Pericardial Effusion

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The Thoracic Surgery Scoring System (Thoracoscore) Accurately Predicts Hospital Mortality in Patients Undergoing Pericardial Window for Malignant Pericardial Effusion.

10.1164/ajrccm-conference.2009.179.1_meetingabstracts.a5507 ◽

2009 ◽

Author(s):

GS Schwartz ◽

J Latif ◽

A Nabong ◽

CP Connery ◽

FY Bhora

Keyword(s):

Pericardial Effusion ◽

Thoracic Surgery ◽

Hospital Mortality ◽

Scoring System ◽

Pericardial Window ◽

Malignant Pericardial Effusion

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Management of Lung Cancer-Associated Malignant Pericardial Effusion with Intrapericardial Administration of Carboplatin: A Retrospective Study

Current Oncology ◽

10.3390/curroncol29010015 ◽

2021 ◽

Vol 29 (1) ◽

pp. 163-172

Author(s):

Hisao Imai ◽

Kyoichi Kaira ◽

Ken Masubuchi ◽

Koichi Minato

Keyword(s):

Lung Cancer ◽

Retrospective Study ◽

Pericardial Effusion ◽

Response To Treatment ◽

Cancer Center ◽

Acute Pericarditis ◽

Malignant Pericardial Effusion ◽

Threatening Condition ◽

Life Threatening

It has been reported that 5.1–7.0% of acute pericarditis are carcinomatous pericarditis. Malignant pericardial effusion (MPE) can progress to cardiac tamponade, which is a life-threatening condition. The effectiveness and feasibility of intrapericardial instillation of carboplatin (CBDCA; 150 mg/body) have never been evaluated in patients with lung cancer, which is the most common cause of MPE. Therefore, we evaluated the effectiveness and feasibility of intrapericardial administration of CBDCA following catheter drainage in patients with lung cancer-associated MPE. In this retrospective study, 21 patients with symptomatic lung cancer-associated MPE, who were administered intrapericardial CBDCA (150 mg/body) at Gunma Prefectural Cancer Center between January 2005 and March 2018, were included. The patients’ characteristics, response to treatment, and toxicity incidence were evaluated. Thirty days after the intrapericardial administration of CBDCA, MPE was controlled in 66.7% of the cases. The median survival period from the day of administration until death or last follow-up was 71 days (range: 10–2435 days). Grade 1–2 pain, nausea, fever, and neutropenia were noted after intrapericardial CBDCA administration. No treatment-related deaths were noted in the current study. Intrapericardial administration of CBDCA (150 mg/body) did not cause serious toxicity, and patients exhibited promising responses to lung cancer-associated MPE. Prospective studies using larger sample sizes are needed to explore the efficacy and safety of this treatment for managing lung cancer-associated MPE.

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Incarcerated intrapericardial diaphragmatic hernia after laparoscopic pericardial window for malignant pericardial effusion

Journal of Clinical Images and Medical Case Reports ◽

10.52768/2766-7820/1300 ◽

2021 ◽

Vol 2 (5) ◽

Author(s):

Ekhlas S Bardisi ◽

◽

Luning Redmer ◽

Luk Verlaeckt ◽

Filip Vanrykel ◽

...

Keyword(s):

Pericardial Effusion ◽

Diaphragmatic Hernia ◽

Lung Ventilation ◽

Pericardial Tamponade ◽

Pericardial Window ◽

Malignant Pericardial Effusion ◽

Minimally Invasive Surgical ◽

Thoracic Drainage ◽

Treatment Measures ◽

Intrapericardial Diaphragmatic Hernia

Laparoscopic Pericardial Window (LPW) is a safe, minimally invasive surgical technique for treating pericardial effusion/tamponade. This technique allows adequate decompression and avoids single-lung ventilation and the need for thoracic drainage in severely ill patients; it also provides anatomopathological and microbiological diagnosis leading to treatment measures. An intrapericardial diaphragmatic hernia is among the rarest complications of this procedure. A 85-year-old man, who underwent LPW for pericardial tamponade, presented to the emergency department 12 days post-operative with bowel obstruction; CT scan showed an incarcerated hernia into the pericardial sac. Laparoscopic reduction and hernia repair were performed using a large-pore Mesh to allow further drainage of histologically proven malignant pericardial effusion. Keywords: pericardial tamponade; pericardial window; surgical drainage of pericardial effusion; intra-pericardial diaphragmatic hernia.

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