A Case of Transverse Colon Cancer Discovered due to Cardiac Tamponade

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Key Points

To report an extremely rare case of advanced transverse colon cancer initially detected following the onset of cardiac tamponade and acute heart failure.
Clinical and laboratory evaluation of a 64-year-old female presenting with general fatigue and elevated liver enzymes.
Diagnostic workup using abdominal ultrasonography, echocardiography, therapeutic pericardiocentesis with cytological examination, contrast-enhanced CT, MRI, and colonoscopy.
Echocardiography identified massive circumferential pericardial effusion and reduced left ventricular ejection fraction, while pericardiocentesis cytology confirmed atypical malignant cells indicating carcinomatous cardiac tamponade.
Further staging via thoracoabdominal contrast CT, MRI, and colonoscopy demonstrated circumferential type 2 transverse colon cancer, mediastinal and para-aortic lymphadenopathy, left adrenal enlargement, and thoracic (Th7) and lumbar (L5) vertebral bone metastases, establishing a diagnosis of cStage IVb transverse colon cancer.

P

Population

64-year-old female presenting with general fatigue, found to have cardiac tamponade and right heart failure

I

Intervention

Pericardiocentesis and diagnostic imaging (echocardiography, CT, MRI, endoscopy)

O

Outcome

Diagnosis of underlying malignancy

Highlights an extremely rare case where transverse colon cancer initially manifested as malignant cardiac tamponade.

Alerts clinicians to rare malignancy in unexplained tamponade; extends case literature but leaves diagnostic implications open.

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MINAMIURA et al. (2023) studied this question.

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