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Cardiac Tamponade Unmasking Recurrent Ovarian Cancer
Pericardial disease is a common manifestation of malignancy. Gynecologic malignancies such as ovarian cancer rarely present with cardiac involvement. Cardiac tamponade may be the initial presentation of malignancy in as many as half of pericardial disease cases. We report the case of a 60-year-old f...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8184109/ https://www.ncbi.nlm.nih.gov/pubmed/34113528 http://dx.doi.org/10.7759/cureus.15464 |
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author | Maryniak, Andrii Oleszak, Filip Biskupski, Patrick Wengrofsky, Perry Lee, Yi-Chun |
author_facet | Maryniak, Andrii Oleszak, Filip Biskupski, Patrick Wengrofsky, Perry Lee, Yi-Chun |
author_sort | Maryniak, Andrii |
collection | PubMed |
description | Pericardial disease is a common manifestation of malignancy. Gynecologic malignancies such as ovarian cancer rarely present with cardiac involvement. Cardiac tamponade may be the initial presentation of malignancy in as many as half of pericardial disease cases. We report the case of a 60-year-old female with known ovarian adenocarcinoma, who achieved initial success with tumor debulking and adjuvant chemotherapy but was lost to follow-up. She presented again three years later with new-onset dyspnea and described a syncopal episode. A chest radiograph showed an enlarged cardiac silhouette and bilateral pleural effusions. Transthoracic echocardiography revealed a large pericardial effusion with diastolic collapse of the right atrium and ventricle, consistent with tamponade physiology. Subxiphoid pericardiocentesis and pigtail drain were placed under fluoroscopy with resolution of symptoms and no recurrence. Neoplastic etiology was confirmed by immunocytochemistry on cell block positive for PAX-8. As an adjunct or alternative to cytologic evaluation, diffusion-weighted magnetic resonance imaging and calculation of the apparent diffusion coefficient can be used to differentiate between malignant and benign effusions. Malignant pericardial effusion in ovarian cancer is a treatable oncologic emergency where timely diagnosis and management may facilitate palliation and prolong life. |
format | Online Article Text |
id | pubmed-8184109 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-81841092021-06-09 Cardiac Tamponade Unmasking Recurrent Ovarian Cancer Maryniak, Andrii Oleszak, Filip Biskupski, Patrick Wengrofsky, Perry Lee, Yi-Chun Cureus Cardiology Pericardial disease is a common manifestation of malignancy. Gynecologic malignancies such as ovarian cancer rarely present with cardiac involvement. Cardiac tamponade may be the initial presentation of malignancy in as many as half of pericardial disease cases. We report the case of a 60-year-old female with known ovarian adenocarcinoma, who achieved initial success with tumor debulking and adjuvant chemotherapy but was lost to follow-up. She presented again three years later with new-onset dyspnea and described a syncopal episode. A chest radiograph showed an enlarged cardiac silhouette and bilateral pleural effusions. Transthoracic echocardiography revealed a large pericardial effusion with diastolic collapse of the right atrium and ventricle, consistent with tamponade physiology. Subxiphoid pericardiocentesis and pigtail drain were placed under fluoroscopy with resolution of symptoms and no recurrence. Neoplastic etiology was confirmed by immunocytochemistry on cell block positive for PAX-8. As an adjunct or alternative to cytologic evaluation, diffusion-weighted magnetic resonance imaging and calculation of the apparent diffusion coefficient can be used to differentiate between malignant and benign effusions. Malignant pericardial effusion in ovarian cancer is a treatable oncologic emergency where timely diagnosis and management may facilitate palliation and prolong life. Cureus 2021-06-05 /pmc/articles/PMC8184109/ /pubmed/34113528 http://dx.doi.org/10.7759/cureus.15464 Text en Copyright © 2021, Maryniak et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Cardiology Maryniak, Andrii Oleszak, Filip Biskupski, Patrick Wengrofsky, Perry Lee, Yi-Chun Cardiac Tamponade Unmasking Recurrent Ovarian Cancer |
title | Cardiac Tamponade Unmasking Recurrent Ovarian Cancer |
title_full | Cardiac Tamponade Unmasking Recurrent Ovarian Cancer |
title_fullStr | Cardiac Tamponade Unmasking Recurrent Ovarian Cancer |
title_full_unstemmed | Cardiac Tamponade Unmasking Recurrent Ovarian Cancer |
title_short | Cardiac Tamponade Unmasking Recurrent Ovarian Cancer |
title_sort | cardiac tamponade unmasking recurrent ovarian cancer |
topic | Cardiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8184109/ https://www.ncbi.nlm.nih.gov/pubmed/34113528 http://dx.doi.org/10.7759/cureus.15464 |
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