Malignant pericardial effusion and cardiac tamponade originating from uterine carcinosarcoma.
BACKGROUND
Cardiac tamponade caused by gynecologic malignancies are extremely rare.


METHODS
A 56-year-old woman was referred to our hospital with vaginal bleeding and abdominal distension. Computed tomography showed massive peritoneal fluid, peritoneal dissemination, swelling of the paraaortic lymph nodes and liver metastasis. Endometrial biopsy showed an admixture of both carcinomatous and sarcomatous elements. The final pathological diagnosis was uterine carcinosarcoma, homologous type. After four cycles of chemotherapy consisting of ifosfamide, adriamycin, and cisplatin, we performed laparotomy, and then two additional courses of chemotherapy were administered postoperatively. Eight months after chemotherapy, echocardiography demonstrated massive pericardial effusion with features of tamponade such as diastolic compression of the right ventricle. Cytological examination of the pericardial fluid showed two different cellular patterns, epithelial and non-epithelial components.


CONCLUSIONS
Although cardiac tamponade is rare and has a poor prognosis, it is important for physicians to consider this possibility in the course of treating of uterine carcinosarcoma.
Department of Obstetrics and Gynecology, Faculty of Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan. shoko@obgy.twmu.ac.jp
Shoko
S
Shimizu
Masazumi
M
Yajima
Asuka
A
Yoshii
Toshio
T
Nishikawa
Hiroaki
H
Ohta
D002296:Carcinosarcoma / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D002305:Cardiac Tamponade / Q000209:etiology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008875:Middle Aged; D010490:Pericardial Effusion / Q000473:pathology*; D014594:Uterine Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000473:pathology