Pericardial Disease in Patients with Cancer: Clinical Insights on Diagnosis and Treatment

• Published in: Cancers Vol. 16; no. 20; p. 3466
• Main Authors: Lorenzo-Esteller, Laia, Ramos-Polo, Raúl, Pons Riverola, Alexandra, Morillas, Herminio, Berdejo, Javier, Pernas, Sonia, Pomares, Helena, Asiain, Leyre, Garay, Alberto, Martínez Pérez, Evelyn, Jiménez-Marrero, Santiago, Alcoberro, Lidia, Nadal, Ernest, Gubern-Prieto, Paula, Gual-Capllonch, Francisco, Hidalgo, Encarna, Enjuanes, Cristina, Comin-Colet, Josep, Moliner, Pedro
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 12.10.2024; MDPI
• Subjects: Antiarthritic agents; Antimitotic agents; Antineoplastic agents; Breast cancer; Cancer; Cancer patients; Cancer therapies; Care and treatment; Cellular biology; Chemotherapy; Colchicine; Complications and side effects; Corticosteroids; Cytostatic agents; Development and progression; Diagnosis; Drug dosages; Effusion; Epidemiology; Etiology; Gastrointestinal diseases; Immune checkpoint inhibitors; Immunosuppressive agents; Immunotherapy; Infections; Leukemia; Lung cancer; Lymphoma; Melanoma; Metastases; Multidisciplinary teams; Non-Hodgkin's lymphomas; Nonsteroidal anti-inflammatory drugs; Patients; Pericarditis; Pericardium; Prognosis; Quality of life; Radiation therapy; Radiotherapy; Rare diseases; Review; Steroid hormones; Steroids; Tamponade; Tetracycline; Tetracyclines; Tomography; Toxicity; Tumors; Spain; radiotherapy; pericardiocentesis; cancer; pericardial disease; chemotherapy
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers16203466

Pericardial disease is increasingly recognized in cancer patients, including acute pericarditis, pericardial effusion, and constrictive pericarditis, often indicating a poor prognosis. Acute pericarditis arises from direct tumor involvement, cancer therapies, and radiotherapy. Immune checkpoint inhibitor (ICI)-related pericarditis, though rare, entails significant mortality risk. Treatment includes NSAIDs, colchicine, and corticosteroids or anti-IL1 drugs in refractory cases. Pericardial effusion is the most frequent manifestation, primarily caused by lung cancer, followed by breast cancer, lymphoma, leukemia, gastrointestinal tumors, and melanoma. Chemotherapy, immunotherapy, and radiotherapy may also cause fluid accumulation in the pericardial space. Symptomatic relief for pericardial effusion may require pericardiocentesis, prolonged catheter drainage, or a pericardial window. Instillation of intrapericardial cytostatic agents may reduce recurrence. Constrictive pericarditis, though less common, often develops from radiotherapy and requires multimodality imaging for diagnosis, with pericardiectomy as the definitive treatment. Primary pericardial tumors are rare, with metastases being more frequent. Patients with cancer and pericardial disease generally have poor survival, emphasizing the need for early detection. A multidisciplinary approach involving hematologists, oncologists, and cardiologists is crucial to tailoring pericardial disease treatment to a patient's clinical status, thereby improving the quality of life and prognosis.