Cardiac tamponade as the first clinical sign of gastric adenocarcinoma: a rare condition

Abstract

Cardiac tamponade originating from a primary gastric cancer (GC) is a rare condition. Patients are generally asymptomatic until the disease is advanced. We report a rare patient with cardiac tamponade as the first manifestation of primary GC. A 46-year-old male was admitted with progressive dyspnea. Cardiac tamponade was diagnosed on two-dimensional ultrasonographic echocardiography. Pericardiocentesis yielded 1500 ml of bloody fluid. Pericardial cytologic examination was positive for malignant cells. The patient underwent abdominal computed tomography scan, which showed thickening of the gastric wall and several mesenteric lymph nodes. Endoscopic examination of the stomach disclosed malignant ulcer along the lesser curvature, and the biopsy showed diffuse type adenocarcinoma. Chemotherapy was initiated by the Oncology Department, and he had no pericardial effusion after six courses of systemic chemotherapy. In conclusion, this is a rare condition and difficult to diagnosis early. Thus, physicians should be aware of malignancy of the stomach when patients present with unexplained cardiac manifestations.

Metastastic Gastric Adenocarcinoma: Diagnosis through Pericardioscopy

“…Pour malignant pericardial is a complication that can be related to neoplastic disease on which, if not diagnosed and quickly conducted it can be potentially deadly [6]. The breast carcinoma, melanoma and lymphoma tumors are the most related to pericardial metastases.…”

Pericardial effusion-induced subcutaneous edema in the trunk and lower limbs after percutaneous drainage for carcinomatous pericarditis: report of a case

“…Based on an analysis of 17 cases of gastric cancer-induced neoplastic cardiac tamponade, Kobayashi et al suggested that systematic chemotherapy may facilitate long-term survival, although they did not observe any statistically significant differences in survival [6]. For gastric cancer-induced carcinomatous pericarditis, the following systematic chemotherapies have been reported to be useful in previous case reports and case series: S-1, S-1 + cisplatin, oxaliplatin + 5-fluorouracil + leucovorin, S-1 + Irinotecan, and docetaxel [6][7][8][9][10][11]. Nonetheless, complete cure is difficult [6][7][8][9][10][11].…”

“…For gastric cancer-induced carcinomatous pericarditis, the following systematic chemotherapies have been reported to be useful in previous case reports and case series: S-1, S-1 + cisplatin, oxaliplatin + 5-fluorouracil + leucovorin, S-1 + Irinotecan, and docetaxel [6][7][8][9][10][11]. Nonetheless, complete cure is difficult [6][7][8][9][10][11].…”

Cardiac tamponade due to advanced gastric cancer: a pathomorphological systematic review of clinical cases

“…Під час аналізу виявлено 3 повідомлення про клінічний прояв РШ у вигляді ТС. УП внаслідок шлункової патології зустрічається вкрай рідко, і більшість повідомлень стосуються шлунково-перикардіальних фістул (ШПФ) [4,20]. У всьому світі опубліковано лише близько 65 повідомлень про ШПФ [4].…”