title: [Symptomatic pericardial effusion as initial manifestation of gastric signet ring cell carcinoma].
abstract: METHODS
  A 78-year-old woman presented at our hospital with palpitation, tachycardia and progressive dyspnea. The health history included the diagnosis of diabetes mellitus and chronic obstructive pulmonary disease.
  
  
  METHODS
  The ECG showed atrial fibrillation, later changing with sinus rhythm and low voltage. The echocardiography revealed pericardial effusion. The cytology showed signet ring cells from the stomach. Endoscopic study revealed a 3 cm tumor in the posterior wall of the upper part of the body. The histopathological examination diagnosed cancer of diffuse type according to Lauren, with signet-ring cells.
  
  
  METHODS
  After treating the atrial fibrillation a pericardial drainage was performed. The pericardiocentesis yielded 500 ml of serous fluid. In an echocardiogram after pericardial drainage, pericardial effusion was no longer present. During the clinical course the patient suffered a stroke and the chemotherapy could not be initiated. The patient died 2 months after diagnosis.
  
  
  CONCLUSIONS
  Cardiac involvement with clinical manifestations and pericardial effusion may be associated with a malignant neoplasm. Echocardiography and pericardiocentesis are helpful for the diagnosis of cardiac metastases.
authors.affiliation: Medizinische Klinik C, Klinikum der Stadt Ludwigshafen gGmbH, Ludwigshafen am Rhein. MedCLu@t-online.de
authors.forename: L
authors.initials: L
authors.lastname: Funk
authors.forename: D
authors.initials: D
authors.lastname: Hartmann
authors.forename: D
authors.initials: D
authors.lastname: Apel
authors.forename: A
authors.initials: A
authors.lastname: Spiethoff
authors.forename: R
authors.initials: R
authors.lastname: Schiele
authors.forename: D
authors.initials: D
authors.lastname: Schilling
authors.forename: H E
authors.initials: HE
authors.lastname: Adamek
authors.forename: J F
authors.initials: JF
authors.lastname: Riemann
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D018279:Carcinoma, Signet Ring Cell / Q000150:complications / Q000175:diagnosis*; D004322:Drainage; D004417:Dyspnea; D017809:Fatal Outcome; D005260:Female; D005773:Gastroscopy; D006801:Humans; D010490:Pericardial Effusion / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D020519:Pericardiocentesis; D013274:Stomach Neoplasms / Q000150:complications / Q000175:diagnosis*; D013610:Tachycardia; D014463:Ultrasonography
vernacular_title: Symptomatischer Perikardergussals Erstmanifestation eines Siegelringzell-Magenkarzinoms.