Treating a Metastatic Pericardial Tumor

Background: Pericardial involvement of metastatic adenocarcinoma is rare, and its treatment has historically involved several strategies. Case Summary: We describe a case of pericardial metastasis from gastrointestinal adenocarcinoma presenting with pericardial syndrome of effusive-constrictive peri...

Full description

Saved in:
Bibliographic Details
Main Authors: Leslie A. Ynalvez, MD, Cezar A. Iliescu, MD, Ihab R. Hamzeh, MD, Anita Deswal, MD, MPH, Nicolas L. Palaskas, MD
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:JACC: Case Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S266608492500645X
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849706564864180224
author Leslie A. Ynalvez, MD
Cezar A. Iliescu, MD
Ihab R. Hamzeh, MD
Anita Deswal, MD, MPH
Nicolas L. Palaskas, MD
author_facet Leslie A. Ynalvez, MD
Cezar A. Iliescu, MD
Ihab R. Hamzeh, MD
Anita Deswal, MD, MPH
Nicolas L. Palaskas, MD
author_sort Leslie A. Ynalvez, MD
collection DOAJ
description Background: Pericardial involvement of metastatic adenocarcinoma is rare, and its treatment has historically involved several strategies. Case Summary: We describe a case of pericardial metastasis from gastrointestinal adenocarcinoma presenting with pericardial syndrome of effusive-constrictive pericarditis (ECP), managed with pericardiocentesis and drain placement followed by 10 cycles of systemic chemotherapy, leading to the resolution of pericardial disease and improved quality of life. Discussion: Treatment strategies for malignant ECP in lieu of pericardiectomy have included pericardiocentesis only or pericardiocentesis with chemotherapy (either local, systemic, or both). Our approach at MD Anderson Cancer Center is to perform pericardiocentesis with temporary pericardial drain placement to decrease reaccumulation rate, followed by systemic chemotherapy to reduce pericardial tumor infiltration but limit sclerosing effect. Take-Home Message: The combination of pericardiocentesis with drain placement for 3 to 5 days postpericardiocentesis followed by systemic chemotherapy can be a successful treatment strategy in ECP due to metastatic pericardial disease.
format Article
id doaj-art-07670501e9664facbf0995526efbe19a
institution DOAJ
issn 2666-0849
language English
publishDate 2025-07-01
publisher Elsevier
record_format Article
series JACC: Case Reports
spelling doaj-art-07670501e9664facbf0995526efbe19a2025-08-20T03:16:10ZengElsevierJACC: Case Reports2666-08492025-07-01301710386710.1016/j.jaccas.2025.103867Treating a Metastatic Pericardial TumorLeslie A. Ynalvez, MD0Cezar A. Iliescu, MD1Ihab R. Hamzeh, MD2Anita Deswal, MD, MPH3Nicolas L. Palaskas, MD4Address for correspondence: Dr Leslie A. Ynalvez, Department of Cardiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030, USA.; Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USADepartment of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USADepartment of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USADepartment of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USADepartment of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USABackground: Pericardial involvement of metastatic adenocarcinoma is rare, and its treatment has historically involved several strategies. Case Summary: We describe a case of pericardial metastasis from gastrointestinal adenocarcinoma presenting with pericardial syndrome of effusive-constrictive pericarditis (ECP), managed with pericardiocentesis and drain placement followed by 10 cycles of systemic chemotherapy, leading to the resolution of pericardial disease and improved quality of life. Discussion: Treatment strategies for malignant ECP in lieu of pericardiectomy have included pericardiocentesis only or pericardiocentesis with chemotherapy (either local, systemic, or both). Our approach at MD Anderson Cancer Center is to perform pericardiocentesis with temporary pericardial drain placement to decrease reaccumulation rate, followed by systemic chemotherapy to reduce pericardial tumor infiltration but limit sclerosing effect. Take-Home Message: The combination of pericardiocentesis with drain placement for 3 to 5 days postpericardiocentesis followed by systemic chemotherapy can be a successful treatment strategy in ECP due to metastatic pericardial disease.http://www.sciencedirect.com/science/article/pii/S266608492500645Xcancerconstrictiveechocardiographypericardial effusiontamponade
spellingShingle Leslie A. Ynalvez, MD
Cezar A. Iliescu, MD
Ihab R. Hamzeh, MD
Anita Deswal, MD, MPH
Nicolas L. Palaskas, MD
Treating a Metastatic Pericardial Tumor
JACC: Case Reports
cancer
constrictive
echocardiography
pericardial effusion
tamponade
title Treating a Metastatic Pericardial Tumor
title_full Treating a Metastatic Pericardial Tumor
title_fullStr Treating a Metastatic Pericardial Tumor
title_full_unstemmed Treating a Metastatic Pericardial Tumor
title_short Treating a Metastatic Pericardial Tumor
title_sort treating a metastatic pericardial tumor
topic cancer
constrictive
echocardiography
pericardial effusion
tamponade
url http://www.sciencedirect.com/science/article/pii/S266608492500645X
work_keys_str_mv AT leslieaynalvezmd treatingametastaticpericardialtumor
AT cezarailiescumd treatingametastaticpericardialtumor
AT ihabrhamzehmd treatingametastaticpericardialtumor
AT anitadeswalmdmph treatingametastaticpericardialtumor
AT nicolaslpalaskasmd treatingametastaticpericardialtumor