Papillary serous adenocarcinoma of the ovary diagnosed after malignant pericardial tamponade and embolic stroke.
BACKGROUND
Epithelial carcinomas of the ovary are predominantly an intraperitoneal disease. Reports of epithelial ovarian carcinomas metastatic to the pericardium are rare.


METHODS
A 43-year-old woman was admitted with symptoms of a pericardial tamponade, as well as an embolic cerebrovascular accident, and transferred to the ICU where a pericardiocentesis was performed. Cytology revealed malignant cells in the pericardial fluid. CT scan of the abdomen and pelvis revealed bilateral pelvic masses. A laparotomy revealed a papillary serous adenocarcinoma of ovarian primary and an infarcted spleen with capsular tumor metastases. The malignant cells in the pericardial fluid were consistent with the ovarian primary.


CONCLUSIONS
Ovarian cancer metastasis to the heart and pericardium presented an aggressive variant of tumor spread with significant morbidity and subsequent mortality.
Winter
William E
WE
Department of Obstetrics and Gynecology, Walter Reed Army Medical Center, Washington, DC 20307, USA.
Seidman
Jeffery
J
Krivak
Thomas C
TC
Pujari
Susan G
SG
Boice
Charles R
CR
Carlson
Jay W
JW
D000328:Adult; D002305:Cardiac Tamponade / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D018283:Cystadenocarcinoma, Papillary / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D018284:Cystadenocarcinoma, Serous / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D004617:Embolism; D005260:Female; D006338:Heart Neoplasms / Q000175:diagnosis / Q000556:secondary*; D006801:Humans; D010051:Ovarian Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D010496:Pericardium / Q000473:pathology; D020521:Stroke / Q000150:complications*