Why the study?
Pericardial effusions are seldom the first location of metastasis and presentation of a primary malignancy, often remaining undiagnosed despite poor prognosis.
Massive malignant pericardial effusion as an initial presentation of NSCLC is associated with a very poor prognosis, with survival typically limited to a few months regardless of intervention.
Alerts clinicians to occult malignancy in unexplained effusions; leaves open questions on prevalence and diagnostic pathways.
The most common primary malignancies that affect the pericardium are lung cancers. Typically, pericardial involvement stays undiagnosed, with almost 1-20% of all tumor-related autopsies revealing invasion of the pericardium. Pericardial effusions are seldom the first location of metastasis and presentation of a primary malignancy. Malignant pericardial effusions are usually silent, although they cause dyspnea, chest discomfort, arrhythmias, cough, and, in rare cases, pericardial tamponade. In a patient with tamponade, a high index of tumor-related suspicion is crucial to rule out cancer. Emergency pericardiocentesis is indicated based on the clinical presentation, however, the patient frequently has a bad prognosis regardless of whether treatment is administered or not. In this case series, we report five cases of non-small cell lung cancer (NSCLC) with pericardial effusion as an initial presentation.
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Babu et al. (2022) studied this question.
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