Abstract
IntroductionPericardial effusion as a complication of malignant gynecological disorders is rare. Few cases of endometrial cancer, squamous cell carcinoma of the cervix, ovarian cancer and uterine carcinosarcoma have been previously reported. We report the first case of cardiac tamponade secondary to a cervical adenocarcinoma.Case presentationA 54-year-old Caucasian woman, without any relevant medical history and no gynecological aftercare, was admitted to our hospital emergency room with severe dyspnea. Echocardiography revealed severe pericardial effusion with a swinging heart. An emergency pericardial drainage was performed through a pericardial window, which permitted the draining of 700 mL of bloody fluid and a pericardial biopsy. Cytological examination of the fluid revealed atypical cells, and the biopsy specimen showed tumor emboli suggestive of adenocarcinoma. Magnetic resonance imaging showed a 35 mm cervical lesion indicative of an endocervical tumor. Exploratory laparoscopy revealed diffuse peritoneal lesions and histological examination of cervical curettage showed a poorly differentiated micropapillary adenocarcinoma of the cervix.ConclusionCarcinomatous pericarditis as the first symptom of a malignant gynecological adenocarcinoma has not, to the best of our knowledge, been documented before. This case highlights the extreme severity of pericardial effusion secondary to cervical adenocarcinoma, a sign of advanced disease. Gynecological malignancies have to be considered in cases of neoplastic pericardial effusion.
Highlights
Pericardial effusion as a complication of malignant gynecological disorders is rare
Carcinomatous pericarditis as the first symptom of a malignant gynecological adenocarcinoma has not, to the best of our knowledge, been documented before. This case highlights the extreme severity of pericardial effusion secondary to cervical adenocarcinoma, a sign of advanced disease
Gynecological malignancies have to be considered in cases of neoplastic pericardial effusion
Summary
Pericardial metastases tend to occur as secondary manifestations of the cancer [2,3,6,11]. Where medium-term follow-up has been reported, the outcome of patients with endometrium adenocarcinoma with pericardial effusion was progression to death in two of the four reported cases [1,3]. According to our findings and previous reports, cardiac tamponade can be considered as indicative of a very poor prognosis when it complicates the progression of a cervical or endometrial adenocarcinoma. This case highlights the extreme severity of pericardial effusion secondary to cervical adenocarcinoma, a sign of advanced disease. Author details 1Department of Gynecology Obstetric, Bichat Claude Bernard Hospital, 46 Rue Henri Huchard, 75877 Paris Cedex 18, France. Competing interests The authors declare that they have no competing interests
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