CLINICAL ANALYSIS OF PERICARDITIS CARCINOMATOSA IN OUR HOSPITAL

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Abstract

Background

Pericarditis carcinomatosa (PC) is a rare but important condition that sometimes develops as an oncologic emergency, which affects the prognosis. PC commonly arises from lung cancer, breast cancer, and so on, while PC arising from abdominal malignancy is very rare and little is known about it.

Methods

We retrospectively analyzed 67 patients with PC who were admitted to our hospital from January 2000. In addition to investigating the incidence of PC, the clinical picture of PC arising from abdominal malignancy was reviewed in more detail.

Results

Primary tumors were as follows: lung 48, thymus 5, esophagus 3, stomach 3, uterus 2, colon 2, pancreas 1, pleura 1, lymphoma 1, and mammary gland 1. The PC incidence for each type of cancer was as follows: thymoma 7.9%, lung cancer 1.7%, pleural mesothelioma 0.78%, and less than 0.5% for all others. Eight patients with PC arising from abdominal malignancy were examined in more detail. The time between the first treatment and diagnosis of PC ranged from 2.3 to 71 months, median survival time after diagnosis of PC was 117 days, and the prognosis was poor. Six patients diagnosed with PC due to the development of cardiac tamponade underwent emergent drainage. Among 5 patients initially treated surgically, examination of surgical specimens revealed lymphatic invasion (n = 4), venous invasion (n = 0), and lymph node metastasis (n = 3). Moreover, at the time of PC diagnosis, 8 patients had pleuritis carcinomatosa, 6 had mediastinal lymph node metastases, and 3 had lymphangitis carcinomatosa.

Conclusions

PC arising from abdominal malignancy was rare, but often presented as an oncologic emergency. Abdominal malignancy with massive lymphatic invasion or pleuritis carcinomatosa is considered to be a risk for the development of PC.

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