Chapiolkina Volha, Saadati Homa, Guevara-Rodriguez Nehemias Antonio, Francis-Morel Garry
SBH Health System, Department of Medicine, Internal Medicine, Bronx, NY, USA.
The Ohio State University College of Pharmacy, MS Translational Pharmacology, and Clinical Trial Design, Columbus, OH, USA.
Case Rep Oncol. 2024 Jul 25;17(1):779-787. doi: 10.1159/000540183. eCollection 2024 Jan-Dec.
Lung cancer remains the most common cause of cancer death in the USA and worldwide despite continued advances in lung cancer screening and treatment. Pericardial effusion (PerF) has been found in up to 50% of postmortem patients with cancer; lung and breast cancers are the most frequent malignancies. Furthermore, it is a sign of poor outcomes with fewer than 5 months of survival. Nevertheless, PErF with or without tamponade as a presentation of lung cancer is uncommon.
We present a 72-year-old male without medical history who presented with 1 month of cough with white sputum and shortness of breath, progressively worsening, associated with weight loss (20 pounds). Further studies demonstrated early cardiac tamponade secondary to malignancy.
Cardiac tamponade can arise secondarily from various etiologies and have different presentations depending on the cause. In general, it is a slowly developing and clinically silent disease process. Therefore, malignant PerFs can rarely present with hemodynamic instability and be the initial manifestation of an underlying malignancy. Our case review presents a rare case of metastatic lung adenocarcinoma manifesting as early symptomatic cardiac tamponade and as an emergency. The results might be life-threatening if this presentation is not recognized and managed appropriately. Clinicians must be aware of such atypical presentations of thoracic malignancies to take action adequately.
尽管肺癌筛查和治疗不断取得进展，但肺癌仍是美国和全球癌症死亡的最常见原因。心包积液（PerF）在高达50%的癌症尸检患者中被发现；肺癌和乳腺癌是最常见的恶性肿瘤。此外，它是预后不良的标志，生存期少于5个月。然而，伴有或不伴有心脏压塞的心包积液作为肺癌的一种表现并不常见。
我们报告一名72岁男性，无病史，出现咳嗽伴白痰和气短1个月，症状逐渐加重，并伴有体重减轻（20磅）。进一步检查显示继发于恶性肿瘤的早期心脏压塞。
心脏压塞可继发于各种病因，并根据病因有不同表现。一般来说，它是一个缓慢发展且临床上无症状的疾病过程。因此，恶性心包积液很少表现为血流动力学不稳定，且很少作为潜在恶性肿瘤的初始表现。我们的病例报告展示了一例罕见的转移性肺腺癌，表现为早期有症状的心脏压塞且为急症。如果这种表现未被及时识别和恰当处理，结果可能危及生命。临床医生必须意识到胸部恶性肿瘤的这种非典型表现，以便采取适当行动。
