Pericarditis in malignancy natural history

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S.

Natural history, Prognosis and Complications

Guarded prognosis associated with malignancies is worsened by pericardial effusion and cardiac tamponade. Children may have poor prognosis and thus, prompt detection and treatment of cardiac tamponade improves survival[1][2].

Patients rarely present with cardiac tamponade as their first presentation. Superior vena cava syndrome may occur in few secondary to either coexisting tumor or rapid accumulation of pericardial effusion[3].

Prognosis of symptomatic malignant pericardial disease is grave with a short life expectancy of 2-4 months[4][5][6][7]. While the patients with hematologic[8] or breast cancer[9], or those in whom malignant cells are not present in pericardium[10] have better prognosis in comparison to those with solid tumors, lung cancer[11], etc.

References

  1. Ben-Horin S, Bank I, Guetta V, Livneh A (2006). "Large symptomatic pericardial effusion as the presentation of unrecognized cancer: a study in 173 consecutive patients undergoing pericardiocentesis". Medicine (Baltimore). 85 (1): 49–53. doi:10.1097/01.md.0000199556.69588.8e. PMID 16523053.
  2. Bień E, Stefanowicz J, Aleszewicz-Baranowska J, Połczyńska K, Szołkiewicz A, Stachowicz-Stencel T; et al. (2005). "[Cardio-vascular disorders at the time of diagnosis of malignant solid tumours in children--own experiences]". Med Wieku Rozwoj. 9 (3 Pt 2): 551–9. PMID 16719168.
  3. Tsai MH, Yang CP, Chung HT, Shih LY (2009). "Acute myeloid leukemia in a young girl presenting with mediastinal granulocytic sarcoma invading pericardium and causing superior vena cava syndrome". J Pediatr Hematol Oncol. 31 (12): 980–2. doi:10.1097/MPH.0b013e3181b86ff3. PMID 19956024.
  4. Tsang TS, Seward JB, Barnes ME, Bailey KR, Sinak LJ, Urban LH; et al. (2000). "Outcomes of primary and secondary treatment of pericardial effusion in patients with malignancy". Mayo Clin Proc. 75 (3): 248–53. PMID 10725950.
  5. Gross JL, Younes RN, Deheinzelin D, Diniz AL, Silva RA, Haddad FJ (2006). "Surgical management of symptomatic pericardial effusion in patients with solid malignancies". Ann Surg Oncol. 13 (12): 1732–8. doi:10.1245/s10434-006-9073-1. PMID 17028771.
  6. Cullinane CA, Paz IB, Smith D, Carter N, Grannis FW (2004). "Prognostic factors in the surgical management of pericardial effusion in the patient with concurrent malignancy". Chest. 125 (4): 1328–34. PMID 15078742.
  7. Dequanter D, Lothaire P, Berghmans T, Sculier JP (2008). "Severe pericardial effusion in patients with concurrent malignancy: a retrospective analysis of prognostic factors influencing survival". Ann Surg Oncol. 15 (11): 3268–71. doi:10.1245/s10434-008-0059-z. PMID 18648881.
  8. Dosios T, Theakos N, Angouras D, Asimacopoulos P (2003). "Risk factors affecting the survival of patients with pericardial effusion submitted to subxiphoid pericardiostomy". Chest. 124 (1): 242–6. PMID 12853529.
  9. Girardi LN, Ginsberg RJ, Burt ME (1997). "Pericardiocentesis and intrapericardial sclerosis: effective therapy for malignant pericardial effusions". Ann Thorac Surg. 64 (5): 1422–7, discussion 1427-8. doi:10.1016/S0003-4975(97)00992-2. PMID 9386714.
  10. Neragi-Miandoab S, Linden PA, Ducko CT, Bueno R, Richards WG, Sugarbaker DJ; et al. (2008). "VATS pericardiotomy for patients with known malignancy and pericardial effusion: survival and prognosis of positive cytology and metastatic involvement of the pericardium: a case control study". Int J Surg. 6 (2): 110–4. doi:10.1016/j.ijsu.2007.12.005. PMID 18329349.
  11. García-Riego A, Cuiñas C, Vilanova JJ (2001). "Malignant pericardial effusion". Acta Cytol. 45 (4): 561–6. PMID 11480719.

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