title: Constrictive pericarditis caused by a pericardial-occupying tumor due to esophageal cancer.
abstract: A 61-year-old female was admitted to our hospital for esophageal cancer treatment. Esophagectomy with 2-field lymphadenectomy was performed. Postoperative findings revealed the lesion was a poorly differentiated squamous cell carcinoma invading into the diaphragm and there were no carcinoma cells on the surgical margins. Eight months after surgery, a recurrence was suspected by the presence of tumors at the pericardia, right axillary lymph node and around the descending aorta. The patient was re-admitted for chemotherapy and administrated fluorouracil and cisplatin 4 days after admission. After 7 days, she complained of dysphagia. Esophagogastroduodenoscopy showed no abnormal lesion that could cause the symptom. Computed tomography revealed massive progression of the pericardial tumor, bilateral pleural effusion and congested liver. Echocardiography showed the diffuse pericardial tumor caused restriction of ventricular dilation and hemodynamics of constrictive pericarditis. The patient died 29 days after re-admission. Autopsy revealed squamous cell carcinoma involving the mediatinum and pericardium. The pericardium was completely full of cancer tissue but no fluid. We concluded that the direct cause of death was neoplastic constrictive pericarditis.
authors.affiliation: Department of Gastroenterological Oncology, Hyogo Cancer Center, Kitaoji-cho 13-70, Akashi, Hyogo, 673-8558, Japan, skushida@hp.pref.hyogo.jp.
authors.forename: Saeko
authors.initials: S
authors.lastname: Kushida
authors.forename: Naoki
authors.initials: N
authors.lastname: Takekawa
authors.forename: Takuya
authors.initials: T
authors.lastname: Mimura
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Tsumura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sakamoto
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Tobimatsu
authors.forename: Ikuya
authors.initials: I
authors.lastname: Miki
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tsuda
authors.forename: Hideto
authors.initials: H
authors.lastname: Inokuchi
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000150:complications* / Q000473:pathology*; D004938:Esophageal Neoplasms / Q000473:pathology*; D017809:Fatal Outcome; D005260:Female; D006338:Heart Neoplasms / Q000150:complications* / Q000473:pathology*; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010494:Pericarditis, Constrictive / Q000209:etiology*; D010496:Pericardium