Key result
A 41-year-old male presenting with a large pericardial effusion was diagnosed with an invasive keratinizing squamous cell carcinoma of thymic origin, demonstrating malignant extension as a rare cause.
Why the study?
Malignancy is an insidious cause of pericardial effusion, but most documented cases secondary to malignancy have been attributed to mass effect from benign thymic tumors rather than malignant extension.
Case Report (n=1)
Pericardial effusions can be caused by malignant extension of thymic tumors, highlighting the importance of considering metastatic disease in the differential diagnosis of pericardial effusion with a mediastinal mass.
Consider thymic carcinoma in unexplained pericardial effusions; extends rare etiology literature but leaves open need for prospective validation.
The incidence of pericardial effusion in the U.S. is roughly 3.4% [1]. While most causes of pericardial effusions are indolent and transient, malignancy is a much more insidious cause that cannot be overlooked. Most cases of documented pericardial effusion secondary to malignancy have been due to mass effect from benign thymic tumors, such as thymomas. Our case highlights a 41-year-old male who presented with a dry cough and epigastric pain, found to have a large pericardial effusion and incidental thymic mass. The mass was biopsied and found to be keratinizing squamous cell carcinoma. This case expands our knowledge base as clinicians that pericardial effusions can be caused by malignant extension of tumors, rather than simply by mass effect of benign tumors.
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Whiting et al. (2021) conducted a case report in Pericardial effusion secondary to thymic cancer (n=1). Pericardiocentesis and chemoradiation was evaluated. A 41-year-old male presenting with a large pericardial effusion was diagnosed with an invasive keratinizing squamous cell carcinoma of thymic origin, demonstrating malignant extension as a rare cause.
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