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Japanese Journal of Clinical Oncology 2004 34(10):627-629; doi:10.1093/jjco/hyh109
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© 2004 Foundation for Promotion of Cancer Research

Case Report

Direct Pericardial Involvement of Non-small Cell Lung Cancer Rapidly Developing Pericardial Constriction

Toshihide Wakamatsu1, Tomonobu Koizumi1, Kazuhisa Urushihata1, Keisaku Fujimoto1, Shiniichirou Uchikawa1, Keishi Kubo1, Ayahiko Iwamura2 and Masanobu Yazawa2

1 The First Department of Medicine, Shinshu University School of Medicine, Matsumoto and 2 The Fujimi-Kogen Hospital, Suwa-gun, Nagano, Japan

For reprints and all correspondence: Tomonobu Koizumi, The First Department of Medicine, Shinshu University School of Medicine, Asahi, Matsumoto 390-8621, Japan. E-mail: tomonobu{at}hsp.md.shinshu-u.ac.jp

Received March 10, 2004; accepted July 6, 2004

A 71-year-old male, who had been followed up after being treated with chemo-radiotherapy for non-small cell lung cancer (adenocarcinoma), rapidly developed dyspnea and mild fever. Radiographs showed left pleural effusion and cardiomegaly, and echocardiographic examination revealed echo-free space, suggesting a pericardial effusion. The patient was treated conservatively without any surgical procedures such as pericardiocentesis. Disappearance of the echo-free space was followed by development of pericardial constriction within two months. At post-mortem examination, a direct extension to the pericardium from the primary lesion of the right upper lobe through the mediastinum was observed. The rapid development of pericardial constriction is extremely rare in patients with malignant pericarditis.

Key Words: constrictive pericarditis • cardiac tamponade • lung cancer • cardiac failure


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