A Patient with Recurrent Breast Cancer Showing Long-Term Survival after Developing Pericardial Effusion and Cardiac Tamponade Caused by Carcinomatous Pericarditis

Abstract

Background: Malignant pericardial effusion caused by carcinomatous pericarditis is a complication of advanced malignancy. Breast cancer is the second most important cause of malignant pericardial effusion. Malignant pericardial effusion is the end stage of breast cancer, and the prognosis is very poor. Pericardial effusion may cause cardiac tamponade and sudden death if it is not controlled properly. There is a debate on which is the best method to control pericardial effusion. Case Report: We describe the clinical course of a 55-year-old woman with recurrent breast cancer, pericardial effusion, and cardiac tamponade caused by carcinomatous pericarditis. Thoracoscopic pericardial window was performed to control the pericardial effusion. The patient survived for about 5 years after being diagnosed with pericardial metastases. Conclusion: The observed long-term survival in such a patient with the development of pericardial effusions and cardiac tamponade caused by carcinomatous pericarditis attributable to breast cancer is rare. Thoracoscopic pericardial window was effective in controlling the pericardial effusion.

Remarkable response to pericardial window procedure and weekly docetaxel treatment in a metastatic breast cancer patient with pericardial effusion and cardiac tamponade

“…Interestingly, the patient had survived for about 5 years since first diagnosis with a pericardial metastasis and received many lines of chemotherapy following paclitaxel treatment, including docetaxel. No pericardial effusion was found during the rest of the treatment, 11 as also shown by our case. Furthermore, Einama et al observed that the time taken for paclitaxel to disappear in the pericardial effusion was shorter than for that in the plasma.…”

“…Taxane‐based chemotherapy is among the most effective palliative treatment for MBC. Previously, two reports have shown a good efficacy of single weekly paclitaxel therapy to relieve malignant pericardial effusions and cardiac tamponade in patients with MBC 11,12 . Ikeda et al reported it as a second‐line regimen upon relapse of the cardiac tamponade after an anthracyclin‐based treatment.…”

“…Therefore, in specific populations such as the elderly or cases with poor performance status, weekly docetaxel is recommended, considering its comparable efficacy with lower toxicity than the standard schedule. 10 The successful treatment of a malignant pericardial effusion in patients with breast cancer using weekly paclitaxel has been reported, 11,12 but never specifically reported using weekly docetaxel.…”

Prolonged Drainage and Intrapericardial Bleomycin Administration for Cardiac Tamponade Secondary to Cancer-Related Pericardial Effusion

“…In agreement with available literature, adequate treatment of MPE almost invariably prevents death, and, in suitable patients, affords the administration of systemic treatments. In chemo-sensitive diseases, this can translate into a long life expectancy 30 , 31 : we had 7 patients surviving 1 year or more. Moreover, in patients with HER2 positive breast cancer and in lung cancer patients with EGFR mutation positive disease, targeted treatment may potentially obtain even better results.…”

Sudden cardiac death due to primary malignant pericardial mesothelioma: Brief report and literature review

“…CT as the initial manifestation of primary malignant tumours with no pericardial origin such as lung, urinary bladder, kidney, vagina, ovarian, fallopian tube, endometrium, uterine cervix, colon, stomach, thyroid, thymus, breast, lymphoma, and melanoma have all been reported [[25], [26], [27], [28], [29], [30], [31], [32], [33], [34], [35], [36], [37], [38], [39]]. Furthermore, sudden death due to CT caused by metastatic lung cancer has been mentioned [40,41].…”