Key result
A 35-year-old man with Ortner syndrome and recurrent pericardial effusion was initially diagnosed with tuberculosis but subsequently found to have metastatic adenocarcinoma.
Case Report (n=1)
This case highlights that recurrent pericardial effusion with Ortner syndrome can be caused by metastatic adenocarcinoma, even when initial tests suggest tuberculosis.
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Alerts clinicians to consider malignancy despite TB findings in Ortner syndrome with effusion; leaves open broader validation.
Ortner syndrome is a rare condition characterized by hoarseness of voice in association with a cardiovascular disease. It is caused by compression of the left recurrent laryngeal nerve by the pulmonary artery or left atrium. Mitral stenosis is a well-recognized cause, however, a number of cardiac and non-cardiac conditions have also been described. Prognosis of Ortner syndrome depends on the underlying aetiology as well as the duration of illness. The case presented here describes a 35-year-old man with hoarseness of voice with recurrent pericardial effusion. Initially, a microbiologically proven diagnosis of tuberculous aetiology with resistance to Rifampicin was made; lack of optimum response and recurrence of pericardial effusion lead to subsequent diagnosis of metastatic adenocarcinoma. The patient responded to some extent to systemic and intrapericardial chemotherapy. Immunocompromised state associated with malignancy may predispose to infection including tuberculosis.
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Islam et al. (2013) conducted a case report in Ortner syndrome with recurrent pericardial effusion (n=1). Systemic and intrapericardial chemotherapy was evaluated. A 35-year-old man with Ortner syndrome and recurrent pericardial effusion was initially diagnosed with tuberculosis but subsequently found to have metastatic adenocarcinoma.
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