Cancerous pericarditis presenting as cardiac tamponade in a 68-year-old man with pancreatic adenocarcinoma: a case report

• Published in: Journal of medical case reports Vol. 14; no. 1; p. 213
• Main Authors: Kiryu, Sachie, Ito, Zensho, Ishikawa, Masashi, Akasu, Takafumi, Matsumoto, Yoshihiro, Hirooka, Shinichi, Saruta, Masayuki, Koido, Shigeo
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 07.11.2020; BioMed Central; BMC
• Subjects: Adenocarcinoma; Adenocarcinoma - complications; Adenocarcinoma - diagnosis; Aged; Antibiotics; Antigens; Breast cancer; Cardiac arrhythmia; Cardiac tamponade; Cardiac Tamponade - diagnostic imaging; Cardiac Tamponade - etiology; Case Report; Case reports; Chemotherapy; Diagnosis; Dyspnea; Emergency medical care; Emergency medical services; Heart; Humans; Lung cancer; Male; Medical prognosis; Metastasis; Pancreatic cancer; Pancreatic Neoplasms - complications; Pancreatic Neoplasms - diagnosis; Patients; Pericardial Effusion - diagnostic imaging; Pericardial Effusion - etiology; Pericarditis; Pericarditis - diagnosis; Pericarditis - diagnostic imaging; Pneumonia; Task forces; Tumors; Cardiac tamponade; Pancreatic cancer
• ISSN: 1752-1947; 1752-1947
• DOI: 10.1186/s13256-020-02546-y

Pericardial effusion is a rare complication of pancreatic cancer. We report a case of cardiac tamponade secondary to pancreatic cancer. 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. 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.