Cardiac tamponade as the initial presentation of papillary thyroid carcinoma.
Hypothyroidism is a well known cause of pericardial effusions and cardiac tamponade; thyroid carcinoma metastatic to the heart and pericardium is rarely encountered in clinical practice. The authors report the case of a 68-year-old male who presented in acute distress from cardiac tamponade. Cytological examination of the pericardial and pleural fluid, and histological examination of a pericardial biopsy revealed a metastatic papillary carcinoma with psammoma bodies. Subsequent reexamination of the patient demonstrated a thyroid nodule and bilateral cervical lymphadenopathy. Fine needle aspiration of the thyroid nodule and cervical lymph nodes detected a papillary thyroid carcinoma with metastases to the lymph nodes. The literature relevant to hypothyroidism, thyroid malignancy and cardiac tamponade is briefly reviewed.
Kovacs
C S
CS
Department of Medicine, University of Alberta, Edmonton.
Nguyen
G K
GK
Mullen
J C
JC
Crockford
P M
PM
D000368:Aged; D001707:Biopsy, Needle; D002291:Carcinoma, Papillary / Q000150:complications* / Q000175:diagnosis / Q000556:secondary*; D002305:Cardiac Tamponade / Q000209:etiology* / Q000628:therapy; D017809:Fatal Outcome; D006338:Heart Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000556:secondary*; D006801:Humans; D008297:Male; D010490:Pericardial Effusion / Q000209:etiology / Q000473:pathology; D010491:Pericardial Window Techniques; D010996:Pleural Effusion / Q000209:etiology / Q000473:pathology; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000473:pathology*