Cancerous pericarditis presenting as cardiac tamponade in a 68-year-old man with pancreatic adenocarcinoma: a case repor
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(2020) 14:213
CASE REPORT
Open Access
Cancerous pericarditis presenting as cardiac tamponade in a 68-year-old man with pancreatic adenocarcinoma: a case report Sachie Kiryu1, Zensho Ito1*, Masashi Ishikawa1, Takafumi Akasu1,2, Yoshihiro Matsumoto1, Shinichi Hirooka2, Masayuki Saruta3 and Shigeo Koido1
Abstract Introduction: Pericardial effusion is a rare complication of pancreatic cancer. We report a case of cardiac tamponade secondary to pancreatic cancer. Case presentation: A 68-year-old Japanese man was diagnosed as having pancreatic cancer during surgery and received chemotherapy for 28 months after the diagnosis. He was admitted to the emergency room with severe dyspnea. Echocardiography revealed pericardial effusion with severe hypofunction. Emergency pericardial drainage was performed to maintain hemodynamics, which resulted in the elimination of 450 mL of blood and the maintenance of circulatory dynamics. Cytological examination of the pericardial fluid revealed atypical cells and tumor cells suggesting adenocarcinoma. Conclusions: To our knowledge, pancreatic cancer complicated with cancerous pericarditis has not been previously documented. This case highlights the extreme severity of pericardial effusion, a sign of progressive disease, secondary to pancreatic cancer. In the case of neoplastic pericardial effusion, an extremely poor prognosis must be considered. Keywords: Pancreatic cancer, Cardiac tamponade
Introduction Malignant pericardial effusion caused by carcinomatous pericarditis is a complication of advanced malignancy. Pericardial effusion may cause cardiac tamponade and sudden death if not properly controlled. Cardiac tamponade as a complication of pancreatic cancer is very rare. Cardiac tamponade caused by carcinomatous pericarditis induces the retention of pericardial fluid, causing pericardial effusion, and must be treated promptly as an oncologic emergency [1]. Emergency treatment is necessary to prevent sudden death and relieve symptoms of * Correspondence: [email protected] 1 Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Kashiwa Hospital, 163-1 Kashiwa-shita, Kashiwa, Chiba 277-8567, Japan Full list of author information is available at the end of the article
pericardial effusion in patients with neoplastic cardiac tamponade [2]. To the best of our knowledge, pericardial involvement in patients with pancreatic cancer has never been reported. Here, we report a case of metastatic pancreatic cancer complicated by pericardial effusion.
Case report A 68-year-old Japanese man was suspected of having pancreatic cancer 3 years previously due to an increase in carbohydrate antigen (CA)19-9. Abdominal computed tomography (CT) revealed a 26-mm hypoechoic mass on the head of his pancreas and liver metastasis. Endoscopic ultrasonography (EUS) and fine-needle aspiration (FNA) of the pancreatic mass revealed adenocarcinoma. He was diagnosed as having Stage IV unresectable
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