Primary Lung Adenocarcinoma Presenting as Cardiac Tamponade in a Pregnant Woman

Bigeh, Allison; Trutter, Lindsey; Gulati, Martha

doi:10.1016/j.jaccas.2019.11.067

Cited by 3 publications

(4 citation statements)

References 7 publications

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“…In the literature, only a few cases of lung cancer during pregnancy are described. The care of a pregnant woman with cancer is quite delicate because it requires finding a balance between the treatment of the mother and the potential foetal risk 3 . The treatment goals for this type of patient are to increase maternal survival, to treat the malignant disease while protecting the foetus from the possible side effects of antitumour treatment.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary embolism complicated by tamponade revealing metastatic lung cancer in a woman pregnant with twin: about a case report

Rhalete

Rhazi

Bkiyer

et al. 2023

Annals of Medicine &Amp; Surgery

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Introduction: Lung cancer can be revealed by thromboembolic complications. Its association with pregnancy is becoming more frequent due to the increasing number of smoking women. The care of a pregnant woman with cancer is quite delicate because it requires finding a balance between the treatment of the mother and the potential foetal risk. Case presentation: The authors report the case of a 38-year-old patient, with a twin pregnancy of 16 weeks, complicated by proximal and distal peripheral venous thrombosis of the left lower limb under low molecular weight heparin therapy at a curative dose. A week later, the patient presented to the emergency room with respiratory distress associated with chest pain and low-abundance metrorrhagia. The obstetrical ultrasound performed confirmed the vitality of only one of the two foetuses. The transthoracic ultrasound objectified a very abundant pericardial effusion producing a tamponade, which was drained percutaneously and whose cytological study revealed a liquid rich in tumour cells. After the unfortunate death of the second twin and an endouterine evacuation, a chest computed tomography angiogram demonstrated a bilateral proximal pulmonary embolism associated with bilateral moderate pulmonary effusion as well as multiple thrombosis and secondary aspect liver lesions with a suspicious parenchymal lymph node of the upper lung lobe. A liver biopsy concluded to a secondary hepatic localization of a moderately differentiated adenocarcinoma whose immunohistochemical complement revealed a pulmonary origin. A multidisciplinary consultation meeting leaned towards treatment with neoadjuvant chemotherapy. The patient died 7 months later. Discussion: Venous thromboembolic disease is more common in pregnant women. Delayed diagnosis is common in these cases, resulting in a high rate of locally advanced or metastatic disease. Since the treatment of pregnancy-associated cancer does not rely on a standardized approach, the decision on how to proceed must be made by a multidisciplinary team. Conclusion: The cornerstone of management remains to find the balance between treating the mother as well as possible while preventing the foetus from the possible harm of cytotoxic drugs frequently used to treat lung cancer. Because of the delayed diagnosis, the maternal prognosis often remains poor.

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Section: Discussionmentioning

confidence: 99%

Pulmonary embolism complicated by tamponade revealing metastatic lung cancer in a woman pregnant with twin: about a case report

Rhalete

Rhazi

Bkiyer

et al. 2023

Annals of Medicine &Amp; Surgery

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“…6–10 The only pregnant woman diagnosed previously with cardiac tamponade due to primary lung cancer died within a few months of diagnosis. 5…”

Section: Discussionmentioning

confidence: 99%

“…Pericardial drainage relieves symptoms and prolongs life. Twelve cases of cardiac tamponade from malignancy have been reported during pregnancy [5][6][7][8][9][10][11][12][13][14][15] with mediastinal malignant lymphoma being the most common (five cases). [6][7][8][9][10] The only pregnant woman diagnosed previously with cardiac tamponade due to primary lung cancer died within a few months of diagnosis.…”

Section: Case Reportmentioning

confidence: 99%

“…[6][7][8][9][10] The only pregnant woman diagnosed previously with cardiac tamponade due to primary lung cancer died within a few months of diagnosis. 5 According to a review of 70 cases of lung cancer during pregnancy reported in 2016, 97% were detected at an advanced stage of III-IV. 1 Only 18% of the women survived beyond 12 months of diagnosis.…”

Section: Case Reportmentioning

confidence: 99%

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Cardiac tamponade during pregnancy due to primary lung cancer: A case report

Ito

Watanabe

et al. 2022

Obstet Med

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We report a rare case of cardiac tamponade caused by lung cancer in a pregnant woman. A 32-year-old multiparous pregnant woman was admitted to the hospital at 15 weeks of gestation with a persistent cough and dyspnea. Transthoracic echocardiography revealed a pericardial effusion with evidence of tamponade physiology. Computed tomography (CT) revealed a massive pericardial effusion and a left lung tumor. Pericardial tamponade was successfully treated using pericardiocentesis. She was diagnosed with lung adenocarcinoma stage IVB based on bronchoscopic lung biopsy, which showed adenocarcinoma and CT, which showed brain metastasis. Pregnancy was terminated at 18 weeks of gestation, followed by molecular-targeted therapy with alectinib hydrochloride and whole-brain irradiation. 24 months after treatment initiation the patient is alive without disease progression. Although pericardial tamponade caused by a malignant tumor during pregnancy is a rare and serious life-threatening condition, appropriate diagnosis and prompt treatment can improve maternal prognosis.

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Perikarderguss bei systemischem Lupus erythematodes in der Spätschwangerschaft

Deseive¹,

Scheiermann²,

Starrach

et al. 2022

Geburtshilfe Frauenheilkd

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Obwohl ein systemischer Lupus erythematodes (SLE) häufig Frauen im gebärfähigen Alter betrifft und daher Schwangere mit bekanntem SLE keine Seltenheit sind, stellt die Erstmanifestation eines SLE während der Schwangerschaft eine interdisziplinäre Herausforderung dar. Akute Krankheitsschübe während einer Schwangerschaft erfordern eine enge interdisziplinäre Abstimmung, um sowohl das mütterliche als auch das fetale Wohlergehen zu erhalten.

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Primary Lung Adenocarcinoma Presenting as Cardiac Tamponade in a Pregnant Woman

Abstract: Pericardial effusions are common in pregnancy and often remain asymptomatic. We present a case of cardiac tamponade in a young pregnant female unmasking a diagnosis of primary metastatic lung adenocarcinoma. ( Level of Difficulty: Intermediate. )

Cited by 3 publications

References 7 publications

Pulmonary embolism complicated by tamponade revealing metastatic lung cancer in a woman pregnant with twin: about a case report

Pulmonary embolism complicated by tamponade revealing metastatic lung cancer in a woman pregnant with twin: about a case report

Cardiac tamponade during pregnancy due to primary lung cancer: A case report

Perikarderguss bei systemischem Lupus erythematodes in der Spätschwangerschaft

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