The natural history of lung cancer with pericardial metastases

Quraishi, Mohammed; Costanzi, John J.; Hokanson, Jim

doi:10.1002/1097-0142(19830215)51:4<740::aid-cncr2820510431>3.0.co;2-n

Cited by 40 publications

(29 citation statements)

References 5 publications

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“…Impairment of cardiac function occurs in approximately 30% of patients and is usually attributable to pericardial effusion [8]. The clinical presentation includes shortness of breath, which may be out of proportion to radiographic findings in patients with pericardial effusion or may be the result of associated pleural effusion [11]. Patients may also present with cough, anterior thoracic pain, pleuritic chest pain, or peripheral edema.…”

Section: Discussionmentioning

confidence: 99%

Metastatic adenocarcinoma of pericardium of unknown origin—a case report

Verma¹,

Pokharna²,

Devgarha³

et al. 2011

Indian J Thorac Cardiovasc Surg

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Malignant disease of the pericardium, primary or secondary is uncommon. Secondary tumors are more frequent with predilection for carcinoma. A case of metastatic adenocarcinoma of pericardium is reported which had no evidence of malignancy on clinical examination, blood profile and radiological investigation, and intraoperative finding. Only pericardial biopsy was positive for metastatic adenocarcinoma.A 63 year old male presented to us with history of gradually progressive dyspnoea on exertion 4 month. 2 Dimensional Echocardiography (2 D Echo) revealed large pericardial effusion for which pericardiocentasis was done. The fluid was grossly hemorrhagic and negative for tuberculosis and malignancy. On empirical basis Anti Tubercular Treatment (ATT) was started.After 15 days he again had dyspnea on exertion. On examination liver was enlarged with normal blood pressure and heart rate. 2 D echocardiography showed signs of cardiac tamponade. Pericardial window through thoracotomy was done. Pericardial fluid cytology and pericardial biopsy were again negative for tuberculosis and malignancy. Postoperatively patient had symptomatic relief and was discharged on anti tubercular treatment.After 1 month the patient came for third time with history of dyspnoea on exertion and rest. 2 D Echocardiography showed effusio-constrictive pericarditis with loculated effusion compressing right atrium. Sternotomy was done, pericardium was found thickened, a phrenic to phrenic exicision of pericardium was done. Pericardial biopsy revealed metastatic adenocarcinoma (Fig. 1).The patient was thoroughly investigated for primary but metastatic source could not be found. There were no symptoms related to gastrointestinal system. Routine physical examination except for mild hepatomegaly and blood investigations were also normal. Computed tomographic scan for chest, abdomen, pelvis, and neck had no evidence for malignancy. Anti tubercular was stopped, patient was discharged on diuretics, and patient was doing well in follow up at 6 months.One of the important differential diagnosis was malignant mesothelioma of pericardium which was ruled out by immunohistochemistry markers in which Calretinine was negative and markers were positive for metastatic adenocarcinoma (Figs. 2, 3). DiscussionMetastases to the heart and pericardium are much more common than primary cardiac tumors and are generally associated with a poor prognosis [1,2]. Metastases to the heart were found in 1.23% of 12,485 consecutive autopsies, compared with a 0.056% prevalence of primary cardiac tumors [1]. In autopsies at which a malignant neoplasm was diagnosed, cardiac metastases were found in 9.7-10.7% of cases [3][4][5].

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Section: Discussionmentioning

confidence: 99%

Metastatic adenocarcinoma of pericardium of unknown origin—a case report

Verma¹,

Pokharna²,

Devgarha³

et al. 2011

Indian J Thorac Cardiovasc Surg

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“…In literature a highly variable incidence of cardiac metastases is reported, ranging from 2.3% and 18.3% [8,12]. Shortness of breath is prominent in the clinical presentation, often out of proportion to the radiographic findings, and may be attributed to a pericardial effusion or an associated pleural effusion [13,14]. Presenting complaints also include cough, anterior thoracic pain, pleuritic chest pain, or peripheral edema [15,16].…”

Section: Case Reportmentioning

confidence: 99%

Atrial Metastatic Tumor: Transthoracic and Transesophageal Echocardiograph Imaging

Lampropoulos

2014

J Med Cases

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A 68-year-old male patient was admitted to our hospital because of weakness, dyspnea on exertion and palpitations. Transthoracic and transesophageal echocardiograph revealed a dilated left atrium with an immobile intracavitary mass, without signs of left atrium outflow obstruction. Bronchoscopy was performed and the histopathologic review of the samples obtained was consistent with a primary lung squamous cell carcinoma.

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“…Los lugares frecuentes de metástasis son hígado, hueso, cerebro, ganglios y glándulas suprarrenales (6,9,10) . La metástasis pericárdica no es una manifestación frecuente, pero cuando el pericardio es infiltrado por una neoplasia maligna, esta procede principalmente de una neoplasia pulmonar (11) . Los tumores con potencial metastático que infiltran pericardio son los del pulmón, mama, esófago, linfomas, leucemia, melanoma maligno.…”

Section: Introductionunclassified

Síndrome de Doege Potter y derrame pericárdico, como manifestaciones iniciales de neoplasia pulmonar

2013

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Síndrome de Doege Potter y derrame pericárdico, como manifestaciones iniciales de neoplasia pulmonarResumen Comunicamos el caso de un paciente de 52 años que ingresa a nuestro hospital por presentar derrame pericárdico masivo y manifestaciones de hipoglicemia de manera repetitiva, sin antecedentes de tabaquismo, diabetes mellitus, ni consumo de fármacos. Fue sometido a pericardiocentesis, obteniéndose 1 430 mL de líquido de aspecto serosanguinolento, el mismo que se remitió para estudio, demostrándose un exudado polimorfonuclear, adenosina deaminasa (ADA) positivo y presencia de células compatibles con adenocarcinoma metastático. Se observó en la radiografía de tórax y tomografía axial computarizada pulmonar la presencia de una masa en la región parahiliar izquierda compatible con una neoplasia maligna, con derrame pleural y pericárdico. Se trató de una presentación poco frecuente de neoplasia maligna pulmonar, con metástasis pericárdica, derrame pleural izquierdo y un síndrome paraneoplásico endocrino, caracterizado por hipoglicemia a repetición, como manifestación inicial. Palabras clave: Enfermedades pulmonares; neoplasias; metástasis de la neoplasia; derrame pleural; síndromes paraneoplásicos endocrinos. AbstractA 52 year-old man was admitted to our hospital because of large pericardial effusion and symptoms of recurrent hypoglycaemia. He had no history of smoking or diabetes mellitus and was taking no medication. Diagnostic pericardiocentesis was performed and 1 430 mL of bloody-stained fluid was obtained. The exudate showed neutrophils positive to adenosin deaminase (ADA) test. Chest X-ray and computed tomography showed a left lung hilar mass resembling a lung neoplasm, with pleural and pericardial effusion. It was a lung cancer of unusual presentation, with pleural and pericardial metastasis and a paraneoplastic syndrome characterized by recurrent hypoglycaemia as initial manifestation.

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The natural history of lung cancer with pericardial metastases

Cited by 40 publications

References 5 publications

Metastatic adenocarcinoma of pericardium of unknown origin—a case report

Metastatic adenocarcinoma of pericardium of unknown origin—a case report

Atrial Metastatic Tumor: Transthoracic and Transesophageal Echocardiograph Imaging

Síndrome de Doege Potter y derrame pericárdico, como manifestaciones iniciales de neoplasia pulmonar

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