Hashimoto Yu, Iwata Yoshifumi, Sangen Ryusho, Usuda Daisuke, Kanda Tsugiyasu, Sakamoto Daisuke, Takagi Shou, Sakamoto Shigeru
Department of General Medicine, Kanazawa Medical University Himi Municipal Hospital, Himi, Japan.
Department of Cardiovascular Surgery, Kanazawa Medical University Himi Municipal Hospital, Himi, Japan.
Case Rep Oncol. 2015 Mar 26;8(1):174-8. doi: 10.1159/000381260. eCollection 2015 Jan-Apr.
We describe the case of an 85-year-old man who presented with a large pericardial effusion. The patient was admitted because of anorexia and general malaise. Chest X-ray revealed an increased cardiothoracic ratio and a small amount of bilateral pleural effusion. Two-dimensional ultrasonographic echocardiography showed pericardial effusions with atrial and right ventricular early diastolic collapse, establishing the diagnosis of cardiac tamponade. Signet-ring cell cancer with pericardial involvement was diagnosed by subxiphoid pericardiostomy. The clear fluid was removed through pericardial drainage. The signet-ring cell carcinoma of the stomach was revealed by gastric fiberscope examination after pericardial biopsy proved malignancy. Virchow lymph node metastasis was also found. We diagnosed the patient with gastric cancer stage IV and suggested him the best supportive therapy. He died of cardiac arrest 1 month after best supportive care.
我们描述了一名85岁男性出现大量心包积液的病例。该患者因厌食和全身不适入院。胸部X线显示心胸比增大及少量双侧胸腔积液。二维超声心动图显示心包积液伴心房和右心室舒张早期塌陷，确诊为心脏压塞。经剑突下心包造口术诊断为印戒细胞癌伴心包受累。通过心包引流清除清亮液体。心包活检证实为恶性后，经胃纤维镜检查发现胃印戒细胞癌。还发现了魏尔啸淋巴结转移。我们诊断该患者为IV期胃癌，并建议其接受最佳支持治疗。在接受最佳支持治疗1个月后，他死于心脏骤停。
