Key result
Pericardial metastasis from urothelial carcinoma mimics immune-mediated pericarditis, creating a critical diagnostic challenge.
Why the study?
Clinical documentation of pericardial metastasis in living patients with urothelial carcinoma is rare, and the management of this condition is not well defined.
Case Report (n=2)
Pericardial metastasis is a rare but life-threatening complication of advanced urothelial carcinoma that can present as cardiac tamponade and must be differentiated from immune-mediated pericarditis in patients on checkpoint inhibitors.
Pericardial metastasis warrants consideration in urothelial carcinoma with tamponade on immunotherapy; leaves open prospective validation of diagnostic criteria.
Urothelial carcinoma (UC) is the ninth most diagnosed cancer worldwide, and pericardial dissemination is uncommon. In this case report, we describe the case of a patient in a complete response after chemotherapy with cisplatin/gemcitabine and maintenance avelumab that presented with cardiac tamponade, posteriorly confirmed to be caused by pericardial involvement by UC, and the case of a patient with UC with peritoneal metastasis at diagnosis under carboplatin/gemcitabine treatment, whose disease progressed with pericardial metastasis. The clinical documentation of pericardial metastasis in living patients is rare, and the management of this condition is still not well defined. Therefore, the description of these cases is important to raise awareness of pericardial involvement as a possible manifestation of UC.
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Agostinho et al. (2026) conducted a case report in Urothelial carcinoma with pericardial involvement (n=2). Pericardial involvement by urothelial carcinoma was evaluated. Pericardial metastasis is a rare but severe complication of advanced urothelial carcinoma that presents a critical diagnostic challenge, particularly in differentiating it from immune-mediated pericarditis in patients on immunotherapy.
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