Malignant pericardial tamponade in a patient  with hormone-refractory prostate cancer.
An 82-year-old man who was receiving treatment for prostate cancer and cholangiocellular carcinoma was admitted to our hospital because of chest discomfort and dyspnea. At the time of admission, 16 months after the start of hormone therapy, the prostate-specific antigen level was 454.08 ng/ml. Chest radiography revealed cardiomegaly, and ultrasonography demonstrated significant pericardial effusion. Pericardiocentesis yielded a hemorrhagic exudate, and a routine cytological study revealed malignant cells. It was difficult to determine whether these cells had originated from the prostate cancer or the cholangiocellular carcinoma. However, immunohistochemical analysis of a cell-block section of the pericardial effusion allowed a diagnosis of pericardial metastasis from the prostate cancer. After drainage and intrapericardial injection of cisplatin, the amount of effusion was decreased. After removal of the pericardial drain, the patient was discharged, but the pericardial effusion was found to have accumulated again 1 month later.
Minagawa
Tomonori
T
Department of Urology, Azumino Red Cross Hospital, Azumino, Nagano, Japan. minagaaa2006@yahoo.co.jp
Murata
Yasushi
Y
Uchikawa
Shinichiro
S
Uehara
Takeshi
T
D045784:Abietanes / Q000627:therapeutic use; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000150:complications; D002305:Cardiac Tamponade / Q000209:etiology*; D018281:Cholangiocarcinoma / Q000150:complications; D002945:Cisplatin / Q000627:therapeutic use; D019008:Drug Resistance, Neoplasm; D006338:Heart Neoplasms / Q000556:secondary*; D006801:Humans; D008297:Male; D010490:Pericardial Effusion / Q000188:drug therapy; D010496:Pericardium; D011471:Prostatic Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000473:pathology
D045784:Abietanes; C045490:horminone; D002945:Cisplatin