Direct Pericardial Involvement of Non-small Cell Lung Cancer Rapidly Developing Pericardial Constriction

Abstract

A 71-year-old male, who had been followed up after being treated with chemo-radiotherapy for non-small cell lung cancer (adenocarcinoma), rapidly developed dyspnea and mild fever. Radiographs showed left pleural effusion and cardiomegaly, and echocardiographic examination revealed echo-free space, suggesting a pericardial effusion. The patient was treated conservatively without any surgical procedures such as pericardiocentesis. Disappearance of the echo-free space was followed by development of pericardial constriction within two months. At post-mortem examination, a direct extension to the pericardium from the primary lesion of the right upper lobe through the mediastinum was observed. The rapid development of pericardial constriction is extremely rare in patients with malignant pericarditis.

Cardiac Tamponade Resembling an Acute Myocardial Infarction as the Initial Manifestation of Metastatic Pericardial Adenocarcinoma

“…pericardial constriction due to pnd is more often seen among lung cancer patients. 27 as evidenced by the findings in our case report, cardiac tamponade could resemble an aMi, especially due to sudden onset where the only clinical signs and symptoms observed are chest tightness, severe soB, and dizziness. in the most severe cases, increased intrapericardial pressure leads to direct compression and collapse of epicardial coronary arteries, which results in diminished perfusion, abnormal distribution of blood flow to the myocardium, and compromised ventricular systolic function.…”