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Cardiac tamponade as the first manifestation of lung cancer

MOJ Orthopedics & Rheumatology
Guiomar Hernández García 

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Background: The incidence of metastatic disease in the myocardium and/or pericardium ranges from less than 1 percent to 18 percent of all cancer patients and varies depending on the type of malignancy. The signet ring cell pattern corresponds to an aggressive behavior of the neoplasia, with a 5-year survival of 50%. Case presentation: A 47-year-old woman, a smoker of 20 hashish cigarettes a day since she was 22, who attended the emergency department with a 48-hour history of diffuse abdominal pain with dyspneic sensation and coughing spells without expectoration. A posteroanterior chest radiograph showed a greatly increased cardiothoracic index. The echocardiogram reported the presence of a large pericardial effusion, with a 4-centimeter separation of both pericardial sheets with diastolic collapse of the right atrium and right ventricle. Given the clinical picture of the patient, admission to the Intensive Care Unit was decided, where pericardiocentesis was performed, extracting 2 liters of blood fluid with a hematocrit of 50%. After 48 hours of monitoring, the patient was admitted to Internal Medicine. Conclusions: We present a patient with a cardiac tamponade whose cytology revealed adenocarcinoma with a signet ring cell pattern without being able to define the origin of the neoplasm


disease, blood fluid, medicine