A plasma cell-based pericardial effusion leading to tamponade in a patient with multiple myeloma — a case report and review of the literature

Pericardial Effusion with Tamponade Physiology in a Patient with Multiple Myeloma

“…As stated previously, pericardial effusions secondary to multiple myeloma are very rare, seen in < 1% of cases. 4 Although in our case, the pericardial fluid was determined to be malignant in origin based on flow cytometry and cytology, the rapid re-accumulation of pericardial effusion almost a week after drain placement was presumed to be due to the spontaneous bleeding complications of hyperviscosity syndrome. The medical interventions were unique for this particular patient due to her preference of treatments.…”

“…Per review of literature, doxycycline sclerotherapy for recurrent pericardial effusions secondary to multiple myeloma has not been performed. 4 The decision to attempt bedside doxycycline sclerotherapy highlights the role of shared-decision making between the patient, her family, cardiology, medical oncology, and thoracic surgery in order to respect the patient's wishes to opt for minimally invasive treatment strategies.…”

“…2 Although it has been reported in the literature (approximately 27 cases between 1970 to 2019), malignant pericardial effusion from multiple myeloma is relatively uncommon. 3,4 In addition, a rare but known complication of poorly controlled multiple myeloma is hyperviscosity syndrome, which typically presents as spontaneous hemorrhage of the mucosal membranes, headaches or neurological symptoms. We present a case of a patient with multiple myeloma who was found to have a pericardial effusion with tamponade that was also complicated by hyperviscosity syndrome.…”

Cardiac tamponade in multiple myeloma – A pictorial case review of FDG PET/CT findings

“…Pericardial effusion is a rare manifestation of metastatic extramedullary multiple myeloma . Less than 1% of all multiple myeloma cases present with cardiac involvement, and presentation of cardiac tamponade is even rarer . To date, only 28 cases with such a complication have been reported.…”

“…The presence of cardiac and pericardial involvement in multiple myeloma remains a rare entity. Since 1970, only 28 cases of cardiac tamponade secondary to multiple myeloma have been reported . We present a case of pericardial involvement/cardiac tamponade caused by multiple myeloma and showcase the unique FDG PET/CT findings.…”