Metastatic squamous-cell carcinoma in pericardial effusion: Report of four cases, two with cardiac tamponade

Abstract

For reasons unknown, metastatic squamous‐cell carcinoma is a rare cause of pleural effusions and is even less common in pericardial effusions. A review of all pericardial effusions examined in the Cytology Service at Montefiore Medical Center over a 15‐year (1980–1994) period was undertaken (N = 251). Four cases with metastatic squamous‐cell carcinoma were identified among 39 malignant effusions. Two patients with metastatic squamous‐cell carcinoma presented with cardiac tamponade, and the other two cases had progressive cardiac failure. The diagnostic cells on cytology evaluation were scant in all four cases but exhibited classical features of metastatic squamous carcinoma, such as cytoplasmic keratinization, intercellular bridges, and occasional “pearl” formation. Pericardial biopsies available in three patients, two with cardiac failure and one with cardiac tamponade, were negative. In all four cases the primary tumor was a bronchogenic carcinoma. Metastatic squamous‐cell carcinoma is an uncommon cause of pericardial effusion and usually indicates the presence of a bronchogenic carcinoma with a rapidly fatal outcome. Cytologic examination of pericardial fluid is essential in the evaluation of such patients. Diagn. Cytopathol. 1998;18:422–424. © 1998 Wiley‐Liss, Inc.

Cytomorphological features of metastatic squamous cell carcinoma in serous effusions

“…However, serous effusions caused by SCC are extremely rare. Review of the literature shows a few recent case reports on the cytomorphology of metastatic SCC to serous cavities . The largest series of SCC in serous effusions to date was published in 1989, in which a total of 46 patients with metastatic SCC to pleural, peritoneal or pericardial cavities were identified in 9297 serous effusions during a period of 33 years…”

Relapse with isolated peritoneal metastasis in lung adenocarcinoma: and review of the literature

“…A search of the literature showed that only 1 case report and 2 individual case analyses regarding peritoneal involvement have been published [1, 3, 4]. There are no published reports of lung cancer cases with involvement of only the peritoneum without metastases to other more common regions [2, 5, 6]. …”

“…Median survival was reported as 2 months following peritoneal carcinomatosis in lung cancer patients [1, 2, 5]. Su et al .…”

Intracardiac Metastasis of Esophageal Squamous Cell Carcinoma: Report of a Case

“…in effusions and discussed the cytologic criteria in diagnosis, and reviewed 33 reported cases of metastatic squamous-cell carcinoma in pericardial effusion by cytology or histology. 2) In their review, only one case out of 33 cases reported metastatic squamous-cell carcinoma with primary esophageal cancer.…”

“…1) Cardiac metastases of tumors arising from the esophagus and pericardial effusions caused by metastatic cancer are rare; squamous cell carcinoma causing these events is extremely uncommon. 2) We document a surgical case of a metastatic right ventricular tumor originating from esophageal squamous cell carcinoma.…”