Tegafur‐uracil‐induced pericardial effusion during adjuvant chemotherapy for resected lung adenocarcinoma: A case report

In Japan, oral administration of tegafur‐uracil is recommended as postoperative adjuvant chemotherapy for patients diagnosed with primary lung adenocarcinomas of >2 cm size and staged as IA, IB, and IIA. Reports on chemotherapy‐induced pericardial effusion are rare. Herein, we report a rare case of tegafur‐uracil‐induced pericardial effusion during postoperative adjuvant chemotherapy for primary lung cancer. A 60‐year‐old man underwent left lower lobectomy and mediastinal lymph node dissection for left lower lung adenocarcinoma. Lung cancer was staged as IB, and tegafur‐uracil was administered as postoperative adjuvant chemotherapy from 1 month after the surgery. A computed tomography (CT) scan revealed a pericardial effusion 5 months after the surgery. A malignant pericardial effusion was suspected, and tegafur‐uracil was discontinued. Pericardiocentesis could not be performed owing to a small amount of pericardial effusion. An 18F‐fluorodeoxyglucose (FDG) positron emission tomography/CT scan revealed no abnormal FDG uptake. During a short follow‐up period after discontinuation of tegafur‐uracil, a CT scan revealed a decrease in pericardial effusion, suggesting that the pericardial effusion was induced by tegafur‐uracil. Follow‐up of pericardial effusion is required while administering tegafur‐uracil. In cases of pericardial effusion without symptoms and no suspicious metastatic lesions in other organs, we should be concerned about tegafur‐uracil‐induced pericardial effusion.