High-Grade Serous Ovarian Carcinoma Presenting as Cardiac Tamponade

Figures

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  Figure 1. Presenting Electrocardiogram With Sinus Tachycardia and Low Voltage

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  Figure 2. Apical 4-Chamber View Revealing Large Pericardial Effusion and Systolic Right Atrial Collapse

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  Figure 3. Pericardial Fluid Cytology Confirming Metastatic High-Grade Serous Ovarian Carcinoma Cytopathology photomicrographs: (A) Thin prep slide with Papanicolaou stain shows 3-dimensional clusters of tumor cells. (B) Cell block slide with hematoxylin-eosin stain reveals tumor cells arranged in a flower-like pattern. (C) Immunocytochemical stain with paired box gene 8 (PAX8) demonstrates diffuse positive nuclear stain. (D) Tumor cells are partially positive for estrogen receptor.

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  Figure 4. Echocardiogram After Pericardial Drain Removal Demonstrating No Pericardial Effusion

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  Visual Summary. A Woman in Her 70s With BRCA1-Positive High-Grade Serous Ovarian Carcinoma Metastatic to the Lung Presented With Progressive Dyspnea, Tachycardia, Hypoxemia, and Distant Heart Sounds Echocardiography revealed cardiac tamponade. Pericardiocentesis yielded 420 mL of serosanguinous fluid; cytology demonstrated malignant cells positive for PAX8, WT-1, and ER, confirming pericardial metastasis. The case highlights rare pericardial metastasis and the need for rapid recognition and intervention. BP = blood pressure; BRCA1 = breast cancer gene 1; ER = estrogen receptor; HR = heart rate; PAX8 = paired box gene 8; RA = room air; WT-1 = Wilms tumor 1.