Pericardial disease in the oncology patient

Malignant pericardial disease is a serious and common problem seen in patients with cancer. It is usually due to metastatic spread of the underlying malignancy or a complication of radiation therapy. The patient may have a mild, subtle presentation, as is often seen in the early stages of pericardial effusion, or may experience dramatic hemodynamic compromise, as is seen with cardiac tamponade and constrictive pericarditis. There are many treatment options available that range from simple drainage to thoracic surgery. It is essential that the treating physician choose a treatment plan in the context of the cancer stage and the patient's prognosis. This article discusses the incidence, pathophysiology, clinical presentation, diagnosis, and treatment options in the various types of malignant pericardial disease.