title: Cardiac tamponade due to metastasis from early gastric cancer.
abstract: We report a case of cardiac tamponade caused by metastasis from early gastric cancer. A 44-year-old woman was detected to have an abnormality of the stomach on barium meal during an annual medical checkup. Gastroendoscopy disclosed superficial depressed gastric lesions, and histopathological examination of biopsy specimens revealed the diagnosis of poorly differentiated adenocarcinoma and signet-ring cell carcinoma. Computed tomography (CT) and ultrasonography (US) revealed no evidence of metastasis. We performed distal gastrectomy with regional lymph node dissection. Histopathological examination revealed poorly differentiated adenocarcinoma and signet-ring cell carcinoma confined to the mucosal layer. Lymphatic invasion was detected only in the mucosal region beneath the tumor; however, lymph node metastasis was found in almost half of dissected lymph nodes. Adjuvant chemotherapy was administered on an outpatient basis with 36 courses of mitomycinC infused (8 mg/day) once every 4 weeks. However, 3 years after the surgery, the patient developed cardiac tamponade due to carcinomatous pericarditis. We performed drainage of the malignant effusion and initiated treatment with S-1 and docetaxel. Although the patient showed some clinical improvement, the patient died 15 months after the occurrence of cardiac tamponade.
authors.affiliation: Division of Gastroenterology, General, Breast and Transplant, Department of Surgery for Organ Function and Biological Regulation, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan. ichiro@nms.ac.jp.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Akagi
authors.affiliation: Division of Gastroenterology, General, Breast and Transplant, Department of Surgery for Organ Function and Biological Regulation, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Miyashita
authors.affiliation: Department of Surgery, Mitsubishi Ohkurayama Hospital, Kanagawa, Japan.
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Hashimoto
authors.affiliation: Division of Gastroenterology, General, Breast and Transplant, Department of Surgery for Organ Function and Biological Regulation, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Makino
authors.affiliation: Division of Gastroenterology, General, Breast and Transplant, Department of Surgery for Organ Function and Biological Regulation, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nomura
authors.affiliation: Division of Gastroenterology, General, Breast and Transplant, Department of Surgery for Organ Function and Biological Regulation, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Ohkawa
authors.affiliation: Division of Gastroenterology, General, Breast and Transplant, Department of Surgery for Organ Function and Biological Regulation, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Tsuchiya
authors.affiliation: Division of Gastroenterology, General, Breast and Transplant, Department of Surgery for Organ Function and Biological Regulation, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Tajiri
keywords: Cardiac tamponade; Early gastric cancer; Metastasis; Pericardial effusion