Key result
Malignant pericardial effusion presents as the rare initial sign of occult metastatic colon adenocarcinoma.
Why the study?
Pericardial metastasis from infradiaphragmatic tumors such as colon cancer is rare and poorly described in the literature.
Case Report (n=1)
Unexplained pericardial effusion may signal occult GI malignancy; extends rare metastatic patterns of colon adenocarcinoma but remains hypothesis-generating.
BACKGROUND: Pericardial neoplastic involvement is rarely related to primary tumors of the pericardium and is most often caused by spread from other primary sites, such as lung and breast carcinomas, hematological malignancies (lymphoma and leukemia), and melanoma. Although pericardial metastasis from infradiaphragmatic tumors (such as colon cancers) are rare and poorly described in literature, any neoplasm has the potential to metastasize to the pericardium and heart by either contiguity, lymphatic, or hematological spread. CASE PRESENTATION: A 44-year-old previously healthy male Causasian patient had a sudden onset of dyspnea and wheezing. During investigation with echocardiogram, computed tomography and repeated pericardiocentesis, the cause of malignant pericardial effusion was confirmed as primary manifestation of metastatic colon cancer. The patient was treated with appropriate chemotherapy and presented satisfactory disease control. CONCLUSIONS: This report emphasizes the importance of considering the diagnostic hypothesis of occult neoplasia in a patient with pericardial effusion.
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Neves et al. (2021) conducted a case report in Malignant pericardial effusion secondary to metastatic colon cancer (n=1). Pericardiocentesis and chemotherapy (FOLFOX + bevacizumab) was evaluated. A 44-year-old man presenting with sudden dyspnea and wheezing was diagnosed with malignant pericardial effusion as a rare primary manifestation of occult metastatic colon adenocarcinoma.
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