Pneumopericardium induced by the radial force of a self-expandable metal stent in a patient with gastroesophageal junction adenocarcinoma: A case report

Rationale: Pneumopericardium is a rare clinical finding in cancer patients and is typically associated with direct tumor invasion or postoperative complications, particularly in intrathoracic malignancies, such as lung or esophageal cancer. Patient concerns: Herein, we report the case of a 58-year-old man with advanced gastroesophageal junction adenocarcinoma who developed pneumopericardium and pericarditis in the absence of tumor invasion. Diagnoses: The condition was presumed to result from the radial force exerted by a self-expandable metal stent placed for palliation of dysphagia. Computed tomography revealed the presence of air within the pericardial sac and a direct communication with the stent, without radiological evidence of tumor invasion into the pericardium. Interventions: Given the terminal nature of the disease and lack of response to palliative systemic therapy, the patient was managed conservatively. Outcomes: The patient succumbed to his illness 1.5 months later. Lessons: To the best of our knowledge, this is the 1st reported case of pneumopericardium induced by the radial force of a self-expandable metal stent in a patient with gastroesophageal junction adenocarcinoma, highlighting the importance of clinical vigilance for pneumopericardium, even in the absence of classic risk factors. Early recognition may guide appropriate management and inform prognostic discussions in patients receiving palliative care.