Extracardiac malignancy presenting with cardiac tamponade

The clinicopathologic features of a case of cardiac tamponade as the initial presentation of extracardiac malignancy is reported and compared with those of previously reported cases. The lung was the site of the primary tumor in 58% of the cases. Irrespective of the sites of the primary tumor, mediastinal involvement or intrapulmonary metastases or both were documented in 88% of the cases. Examinations of the pericardial fluid and pericardiectomy specimen were negative in a considerable number of cases. Therefore, careful examination of the mediastinum and the accessible lung tissue at the time of pericardiectomy may reveal the malignant nature of the disease which may otherwise remain undiagnosed.