A 73-year-old man complaining of pain on effort was admitted to a hospital for a percutaneous coronary intervention (PCI) because of severe stenosis of the mid right coronary artery. During PCI, a coronary artery was ruptured, and the patient suddenly went into shock. Percutaneous pericardiocentesis was successfully performed, and cardiac tamponade was relieved. Despite the echocardiographic finding of no cardiac tamponade, the patient remained in the shock state. An emergency operation was performed. There was little pericardial effusion, but a large subepicardial and intramyocardial hematoma was present and was being compressed by the pericardium. Pericardial incision and off-pump coronary artery bypass grafting were performed. The patient was discharged on the 12th postoperative day. Decompression of the subepicardial hematoma by pericardiotomy ameliorated the condition of the patient, who was in cardiogenic shock. We thus report a rare case of subepicardial hematoma resulting in shock during PCI in which cardiac tamponade was not observed.

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Endometrial cancer should be considered in women with inappropriate vaginal bleeding, menstrual abnormalities, or discolored vaginal discharge. We experienced a case without the above risk factors, in which a preliminary diagnosis was made with endometrial cytology. The case was of a 66-year-old woman, gravida 2 and para 2. She had no inappropriate vaginal bleeding, and transvaginal ultrasound examination showed a thin endometrium. However, endometrial cytology was positive. We performed laparoscopic hysterectomy and bilateral salpingo-oophorectomy based on a clinical diagnosis of Stage IA uterine corpus cancer. The postoperative pathologic diagnosis was stage IB Grade 2 endometrial adenocarcinoma. Therefore, the possibility of uterine corpus cancer must still be considered in cases without risk factors. And cytologic sampling should be considered an effective method for diagnosis of uterine corpus cancer because of its high sensitivity and specificity.