Pericarditis in malignancy natural history: Difference between revisions

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{{Pericarditis in malignancy}}
{{Pericarditis in malignancy}}
{{Pericarditis}}


{{CMG}}; '''Associate Editor-In-Chief:''' [[Varun Kumar]], M.B.B.S.; [[Lakshmi Gopalakrishnan]], M.B.B.S.
{{CMG}}; '''Associate Editor-In-Chief:''' [[Varun Kumar]], M.B.B.S.; [[Lakshmi Gopalakrishnan]], M.B.B.S.


==Natural History, Complications and Prognosis==
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==Prognosis==
Guarded prognosis associated with malignancies is worsened by [[pericardial effusion]] and [[cardiac tamponade]]. Children may have poor prognosis and thus, prompt detection and treatment of cardiac tamponade improves survival.<ref name="pmid16523053">{{cite journal| author=Ben-Horin S, Bank I, Guetta V, Livneh A| title=Large symptomatic pericardial effusion as the presentation of unrecognized cancer: a study in 173 consecutive patients undergoing pericardiocentesis. | journal=Medicine (Baltimore) | year= 2006 | volume= 85 | issue= 1 | pages= 49-53 | pmid=16523053 | doi=10.1097/01.md.0000199556.69588.8e | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16523053  }} </ref><ref name="pmid16719168">{{cite journal| author=Bień E, Stefanowicz J, Aleszewicz-Baranowska J, Połczyńska K, Szołkiewicz A, Stachowicz-Stencel T et al.| title=[Cardio-vascular disorders at the time of diagnosis of malignant solid tumours in children--own experiences]. | journal=Med Wieku Rozwoj | year= 2005 | volume= 9 | issue= 3 Pt 2 | pages= 551-9 | pmid=16719168 | doi= | pmc= | url= }} </ref>
Guarded prognosis associated with malignancies is worsened by [[pericardial effusion]] and [[cardiac tamponade]]. Children may have poor prognosis and thus, prompt detection and treatment of cardiac tamponade improves survival.<ref name="pmid16523053">{{cite journal| author=Ben-Horin S, Bank I, Guetta V, Livneh A| title=Large symptomatic pericardial effusion as the presentation of unrecognized cancer: a study in 173 consecutive patients undergoing pericardiocentesis. | journal=Medicine (Baltimore) | year= 2006 | volume= 85 | issue= 1 | pages= 49-53 | pmid=16523053 | doi=10.1097/01.md.0000199556.69588.8e | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16523053  }} </ref><ref name="pmid16719168">{{cite journal| author=Bień E, Stefanowicz J, Aleszewicz-Baranowska J, Połczyńska K, Szołkiewicz A, Stachowicz-Stencel T et al.| title=[Cardio-vascular disorders at the time of diagnosis of malignant solid tumours in children--own experiences]. | journal=Med Wieku Rozwoj | year= 2005 | volume= 9 | issue= 3 Pt 2 | pages= 551-9 | pmid=16719168 | doi= | pmc= | url= }} </ref>


Patients rarely present with cardiac tamponade as their first presentation. [[Superior vena cava syndrome]] may occur in few secondary to either coexisting tumor or rapid accumulation of pericardial effusion.<ref name="pmid19956024">{{cite journal| author=Tsai MH, Yang CP, Chung HT, Shih LY| title=Acute myeloid leukemia in a young girl presenting with mediastinal granulocytic sarcoma invading pericardium and causing superior vena cava syndrome. | journal=J Pediatr Hematol Oncol | year= 2009 | volume= 31 | issue= 12 | pages= 980-2 | pmid=19956024 | doi=10.1097/MPH.0b013e3181b86ff3 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19956024  }} </ref>
Patients rarely present with cardiac tamponade as their first presentation. [[Superior vena cava syndrome]] may occur in some patients secondary to either a coexisting tumor or rapid accumulation of pericardial effusion.<ref name="pmid19956024">{{cite journal| author=Tsai MH, Yang CP, Chung HT, Shih LY| title=Acute myeloid leukemia in a young girl presenting with mediastinal granulocytic sarcoma invading pericardium and causing superior vena cava syndrome. | journal=J Pediatr Hematol Oncol | year= 2009 | volume= 31 | issue= 12 | pages= 980-2 | pmid=19956024 | doi=10.1097/MPH.0b013e3181b86ff3 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19956024  }} </ref>


Prognosis of symptomatic malignant pericardial disease is grave with a short life expectancy of 2-4 months.<ref name="pmid10725950">{{cite journal| author=Tsang TS, Seward JB, Barnes ME, Bailey KR, Sinak LJ, Urban LH et al.| title=Outcomes of primary and secondary treatment of pericardial effusion in patients with malignancy. | journal=Mayo Clin Proc | year= 2000 | volume= 75 | issue= 3 | pages= 248-53 | pmid=10725950 | doi= | pmc= | url= }} </ref><ref name="pmid17028771">{{cite journal| author=Gross JL, Younes RN, Deheinzelin D, Diniz AL, Silva RA, Haddad FJ| title=Surgical management of symptomatic pericardial effusion in patients with solid malignancies. | journal=Ann Surg Oncol | year= 2006 | volume= 13 | issue= 12 | pages= 1732-8 | pmid=17028771 | doi=10.1245/s10434-006-9073-1 | pmc= | url= }} </ref><ref name="pmid15078742">{{cite journal| author=Cullinane CA, Paz IB, Smith D, Carter N, Grannis FW| title=Prognostic factors in the surgical management of pericardial effusion in the patient with concurrent malignancy. | journal=Chest | year= 2004 | volume= 125 | issue= 4 | pages= 1328-34 | pmid=15078742 | doi= | pmc= | url= }} </ref><ref name="pmid18648881">{{cite journal| author=Dequanter D, Lothaire P, Berghmans T, Sculier JP| title=Severe pericardial effusion in patients with concurrent malignancy: a retrospective analysis of prognostic factors influencing survival. | journal=Ann Surg Oncol | year= 2008 | volume= 15 | issue= 11 | pages= 3268-71 | pmid=18648881 | doi=10.1245/s10434-008-0059-z | pmc= | url= }} </ref> While the patients with hematologic<ref name="pmid12853529">{{cite journal| author=Dosios T, Theakos N, Angouras D, Asimacopoulos P| title=Risk factors affecting the survival of patients with pericardial effusion submitted to subxiphoid pericardiostomy. | journal=Chest | year= 2003 | volume= 124 | issue= 1 | pages= 242-6 | pmid=12853529 | doi= | pmc= | url= }} </ref> or breast cancer,<ref name="pmid9386714">{{cite journal| author=Girardi LN, Ginsberg RJ, Burt ME| title=Pericardiocentesis and intrapericardial sclerosis: effective therapy for malignant pericardial effusions. | journal=Ann Thorac Surg | year= 1997 | volume= 64 | issue= 5 | pages= 1422-7; discussion 1427-8 | pmid=9386714 | doi=10.1016/S0003-4975(97)00992-2 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9386714  }} </ref> or those in whom malignant cells are not present in the pericardium<ref name="pmid18329349">{{cite journal| author=Neragi-Miandoab S, Linden PA, Ducko CT, Bueno R, Richards WG, Sugarbaker DJ et al.| title=VATS pericardiotomy for patients with known malignancy and pericardial effusion: survival and prognosis of positive cytology and metastatic involvement of the pericardium: a case control study. | journal=Int J Surg | year= 2008 | volume= 6 | issue= 2 | pages= 110-4 | pmid=18329349 | doi=10.1016/j.ijsu.2007.12.005 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18329349  }} </ref> have a better prognosis in comparison to those with solid tumors, lung cancer,<ref name="pmid11480719">{{cite journal| author=García-Riego A, Cuiñas C, Vilanova JJ| title=Malignant pericardial effusion. | journal=Acta Cytol | year= 2001 | volume= 45 | issue= 4 | pages= 561-6 | pmid=11480719 | doi= | pmc= | url= }} </ref> etc.
Prognosis of symptomatic malignant pericardial disease is grave with a short life expectancy of 2-4 months.<ref name="pmid10725950">{{cite journal| author=Tsang TS, Seward JB, Barnes ME, Bailey KR, Sinak LJ, Urban LH et al.| title=Outcomes of primary and secondary treatment of pericardial effusion in patients with malignancy. | journal=Mayo Clin Proc | year= 2000 | volume= 75 | issue= 3 | pages= 248-53 | pmid=10725950 | doi= | pmc= | url= }} </ref><ref name="pmid17028771">{{cite journal| author=Gross JL, Younes RN, Deheinzelin D, Diniz AL, Silva RA, Haddad FJ| title=Surgical management of symptomatic pericardial effusion in patients with solid malignancies. | journal=Ann Surg Oncol | year= 2006 | volume= 13 | issue= 12 | pages= 1732-8 | pmid=17028771 | doi=10.1245/s10434-006-9073-1 | pmc= | url= }} </ref><ref name="pmid15078742">{{cite journal| author=Cullinane CA, Paz IB, Smith D, Carter N, Grannis FW| title=Prognostic factors in the surgical management of pericardial effusion in the patient with concurrent malignancy. | journal=Chest | year= 2004 | volume= 125 | issue= 4 | pages= 1328-34 | pmid=15078742 | doi= | pmc= | url= }} </ref><ref name="pmid18648881">{{cite journal| author=Dequanter D, Lothaire P, Berghmans T, Sculier JP| title=Severe pericardial effusion in patients with concurrent malignancy: a retrospective analysis of prognostic factors influencing survival. | journal=Ann Surg Oncol | year= 2008 | volume= 15 | issue= 11 | pages= 3268-71 | pmid=18648881 | doi=10.1245/s10434-008-0059-z | pmc= | url= }} </ref> While the patients with hematologic<ref name="pmid12853529">{{cite journal| author=Dosios T, Theakos N, Angouras D, Asimacopoulos P| title=Risk factors affecting the survival of patients with pericardial effusion submitted to subxiphoid pericardiostomy. | journal=Chest | year= 2003 | volume= 124 | issue= 1 | pages= 242-6 | pmid=12853529 | doi= | pmc= | url= }} </ref> or breast cancer,<ref name="pmid9386714">{{cite journal| author=Girardi LN, Ginsberg RJ, Burt ME| title=Pericardiocentesis and intrapericardial sclerosis: effective therapy for malignant pericardial effusions. | journal=Ann Thorac Surg | year= 1997 | volume= 64 | issue= 5 | pages= 1422-7; discussion 1427-8 | pmid=9386714 | doi=10.1016/S0003-4975(97)00992-2 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9386714  }} </ref> or those in whom malignant cells are not present in the pericardium<ref name="pmid18329349">{{cite journal| author=Neragi-Miandoab S, Linden PA, Ducko CT, Bueno R, Richards WG, Sugarbaker DJ et al.| title=VATS pericardiotomy for patients with known malignancy and pericardial effusion: survival and prognosis of positive cytology and metastatic involvement of the pericardium: a case control study. | journal=Int J Surg | year= 2008 | volume= 6 | issue= 2 | pages= 110-4 | pmid=18329349 | doi=10.1016/j.ijsu.2007.12.005 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18329349  }} </ref> have a better prognosis in comparison to those with solid tumors, lung cancer,<ref name="pmid11480719">{{cite journal| author=García-Riego A, Cuiñas C, Vilanova JJ| title=Malignant pericardial effusion. | journal=Acta Cytol | year= 2001 | volume= 45 | issue= 4 | pages= 561-6 | pmid=11480719 | doi= | pmc= | url= }} </ref> etc.
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[[Category:Inflammations]]
[[Category:Inflammations]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Oncology]]


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[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Medicine]]
[[Category:Cardiology]]
[[Category:Surgery]]

Latest revision as of 15:06, 27 November 2017

Pericarditis in malignancy Microchapters

Home

Patient Information

Overview

Pathophysiology

Causes

Differentiating Pericarditis in malignancy from other Diseases

Epidemiology and Demographics

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography

Cardiac Catheterization

Treatment

Approach to Treatment

Medical Therapy

Pericardiocentesis

Pericardial Window

Pericardial Stripping

Case Studies

Case #1

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S.

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Prognosis

Guarded prognosis associated with malignancies is worsened by pericardial effusion and cardiac tamponade. Children may have poor prognosis and thus, prompt detection and treatment of cardiac tamponade improves survival.[1][2]

Patients rarely present with cardiac tamponade as their first presentation. Superior vena cava syndrome may occur in some patients secondary to either a coexisting tumor or rapid accumulation of pericardial effusion.[3]

Prognosis of symptomatic malignant pericardial disease is grave with a short life expectancy of 2-4 months.[4][5][6][7] While the patients with hematologic[8] or breast cancer,[9] or those in whom malignant cells are not present in the pericardium[10] have a better prognosis in comparison to those with solid tumors, lung cancer,[11] etc.

References

  1. ↑ Ben-Horin S, Bank I, Guetta V, Livneh A (2006). "Large symptomatic pericardial effusion as the presentation of unrecognized cancer: a study in 173 consecutive patients undergoing pericardiocentesis". Medicine (Baltimore). 85 (1): 49–53. doi:10.1097/01.md.0000199556.69588.8e. PMID 16523053.
  2. ↑ Bień E, Stefanowicz J, Aleszewicz-Baranowska J, Połczyńska K, Szołkiewicz A, Stachowicz-Stencel T; et al. (2005). "[Cardio-vascular disorders at the time of diagnosis of malignant solid tumours in children--own experiences]". Med Wieku Rozwoj. 9 (3 Pt 2): 551–9. PMID 16719168.
  3. ↑ Tsai MH, Yang CP, Chung HT, Shih LY (2009). "Acute myeloid leukemia in a young girl presenting with mediastinal granulocytic sarcoma invading pericardium and causing superior vena cava syndrome". J Pediatr Hematol Oncol. 31 (12): 980–2. doi:10.1097/MPH.0b013e3181b86ff3. PMID 19956024.
  4. ↑ Tsang TS, Seward JB, Barnes ME, Bailey KR, Sinak LJ, Urban LH; et al. (2000). "Outcomes of primary and secondary treatment of pericardial effusion in patients with malignancy". Mayo Clin Proc. 75 (3): 248–53. PMID 10725950.
  5. ↑ Gross JL, Younes RN, Deheinzelin D, Diniz AL, Silva RA, Haddad FJ (2006). "Surgical management of symptomatic pericardial effusion in patients with solid malignancies". Ann Surg Oncol. 13 (12): 1732–8. doi:10.1245/s10434-006-9073-1. PMID 17028771.
  6. ↑ Cullinane CA, Paz IB, Smith D, Carter N, Grannis FW (2004). "Prognostic factors in the surgical management of pericardial effusion in the patient with concurrent malignancy". Chest. 125 (4): 1328–34. PMID 15078742.
  7. ↑ Dequanter D, Lothaire P, Berghmans T, Sculier JP (2008). "Severe pericardial effusion in patients with concurrent malignancy: a retrospective analysis of prognostic factors influencing survival". Ann Surg Oncol. 15 (11): 3268–71. doi:10.1245/s10434-008-0059-z. PMID 18648881.
  8. ↑ Dosios T, Theakos N, Angouras D, Asimacopoulos P (2003). "Risk factors affecting the survival of patients with pericardial effusion submitted to subxiphoid pericardiostomy". Chest. 124 (1): 242–6. PMID 12853529.
  9. ↑ Girardi LN, Ginsberg RJ, Burt ME (1997). "Pericardiocentesis and intrapericardial sclerosis: effective therapy for malignant pericardial effusions". Ann Thorac Surg. 64 (5): 1422–7, discussion 1427-8. doi:10.1016/S0003-4975(97)00992-2. PMID 9386714.
  10. ↑ Neragi-Miandoab S, Linden PA, Ducko CT, Bueno R, Richards WG, Sugarbaker DJ; et al. (2008). "VATS pericardiotomy for patients with known malignancy and pericardial effusion: survival and prognosis of positive cytology and metastatic involvement of the pericardium: a case control study". Int J Surg. 6 (2): 110–4. doi:10.1016/j.ijsu.2007.12.005. PMID 18329349.
  11. ↑ García-Riego A, Cuiñas C, Vilanova JJ (2001). "Malignant pericardial effusion". Acta Cytol. 45 (4): 561–6. PMID 11480719.

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