Pericardiocentesis and pericardial therapy aspects in cancer patients – a case report Case report
Main Article Content
Abstract
The malignancy related pericardial effusion has variable dynamics, and the clinical presentation and severity of symptoms are directly related to the degree of hemodynamic conditions and the rate of fluid accumulation in the pericardial cavity. Neoplastic pericardial effusion often leads to cardiac tamponade, usually is recurrent, may cause constrictive pericarditis, and sometimes is the first symptom of the neoplastic disease. We present a case report of female patient with malignant pericardial effusion, cardiac tamponade, in which oncologists and cardiologists collaboration led to effective pericardiocentesis and catheter drainage of pericardium. The patient was qualified for local chemotherapy with cisplatin. The intrapericardial treatment resulted in relieving symptoms, reducing recurrence of pericardial effusion and allowed to the continuation of systemic chemotherapy. The following sections discuss the current possibilities of intrapericardial pharmacotherapy.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright: © Medical Education sp. z o.o. This is an Open Access article distributed under the terms of the Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
References
2. Vaitkaus P.T., Herrmann H.C., LeWinter M.M.: Treatment of malignant pericardial effusion. JAMA 1994; 272: 59-64.
3. Millaire A., Wurtz A., de Groote P. et al.: Malignant pericardial effusions: usefulness of pericardioscopy. Am. Heart J. 1992; 124(4): 1030-1034.
4. Porte H.L., Janecki-Delebecq T.J., Finzi L. et al.: Pericardioscopy for primary management of pericardial effusion in cancer patients. Eur. J. Cardiothoracic Surg. 1999; 16(3): 287-91.
5. Maisch B., Seferović P.M., Ristić A.D. et al.: Guidelines on the Diagnosis and Management of Pericardial Diseases; The Task Force on the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology. Eur. Heart J. 2004; 25: 19-20.
6. Tsang T.S., Enriquez-Sarano M., Freeman W.K. et al.: Consecutive 1127 therapeutic echocardiographically guided pericardiocentesis: clinical profile, practice patterns, and outcomes spanning 21 years. Mayo Clin. Proc. 2002; 77: 429-461.
7. Kopecky S.L., Callahan J.A., Tajik A.J., Seward J.B.: Percutaneous pericardial catheter drainage: report of 42 consecutive cases. Am. J. Cardiol. 1986; 58: 633-635.
8. Maher E.A., Shepherd F.A., Todd T.J.: Pericardial sclerosis as the primary management of malignant pericardial effusion and cardiac tamponade. J. Thorac. Cardiovasc. Surg. 1996; 112: 637-643.
9. van der Gaast A., Kok T.C., van der Linden N.H. et al.: Intrapericardial instillation of bleomycin in the management of malignant pericardial effusion. Eur. J. Cancer Clin. Oncol. 1989; 25: 1505-1506.
10. Yano T., Yokohama H., Inoue T. et al.: A simple technique to manage malignanat pericardial effusion with a local instillation of bleomycin in non-small cell carcinoma of the lung. Oncology 1994; 51: 507-509.
11. Liu G., Crump M., Goss P.E. et al.: Prospective comparison of the sclerosing agents doxycycline and bleomycin for the primary management of malignant pericardial effusion and cardiac tamponade. J. Clin. Oncol. 1996; 14: 3141-3147.
12. Lestuzzi C.: Neoplastic pericardial disease: Old and current strategies for diagnosis and management. World J. Cardiol. 2010; 2(9): 270-279.
13. Van Belle S.J., Volckaert A., Taeymans Y. et al.: Treatment of malignant pericardial tamponade with sclerosis inducted by instillation of bleomycin. Int. J. Cardiol. 1987; 16: 155-160.
14. Martinoni A., Cipolla C.M., Cardinale D. et al.: Long-term results of intrapericardial chemotherapeutic treatment of malignant pericardial effusions with thiotepa. Chest 2004; 126: 1412-1416.
15. Lestuzzi C., Viel E., Sorio R. et al.: Local chemiotherapy for neoplastic pericardial effusion. Am. J. Cardiol. 2000; 86: 1292.
16. Luk K.T., Yang P.C., Kuo S.H. et al.: Comparsion of OK-432 and mitomycin C pleurodesis for malignant pleural effusion caused by lung cancer. A randomized trial. Cancer 1992; 69: 674-679..
17. Imamura T., Tamura K., Takenaga M. et al.: Intrapericardial OK.-432 instillation for the management of malignant pericardial effusion. Cancer 1991; 68: 259-263.
18. Lissoni P., Barni S., Tancini G. et al.: Intracavitary therapy of neoplastic effusions with cytokines: comparsions among interferon alpha, beta and interleukin-2. Support Care Cancer 1995; 3: 78-80.
19. Bishiniotis T.S., Antoniadou S., Katseas G. et al.: Malignant cardiac tamponade in women with breast cancer treated by pericardiocentesis and intrapericardial administration of triethylenethiophosphoramide (thiotepa). Am. J. Cardiol. 2000; 86(3): 362-4.
20. Colleoni M., Martinelli G., Beretta F. et al.: Intracavitary chemiotherapy with thiotepa in malignant pericardial effusion: an active and well tolerated regimen. J. Clin. Oncol. 1998; 16: 2371-6.
21. Girardi L.N., Ginsberg R.J., Burt M.E.: Pericardiocentesis and intrapericardial sclerosis: effective therapy for malignant pericardial effusion. Ann. Thorac. Surg. 1997; 64: 1422-8.
22. Lestuzzi C., Bearz A., Lafaras C. et al.: Neoplastic pericardial disease in lung cancer: Impact on outcomes of different treatment strategies. A multicenter study. Lung Cancer 2011; 72(3): 340-7.