[Pericardial effusion in patients with malignant neoplasms]

Pericardial effusions are often present in patients suffering from tumoral diseases, especially lung and breast cancers. Between September 1984 and February 1991 we observed 21 patients with "malignant pericarditis", of whom 57% had carcinoma of the bronchus and 33% a carcinoma of the breast. The symptoms most frequently seen were dyspnea (in 76% of the patients) and tachycardia (67%), accompanied by enlargement of the heart on chest radiograph. The effusions were bloody in all the patients, and the pericardial fluid cytology was positive in 9 of 10 of the lung cancer patients. 16 patients were treated by pericardiocentesis and in 10 of these thiotepa and hydrocortisone were instilled intrapericardially. In this manner it was possible to avoid recurrences of major effusion. The survival of the patients who received the intrapericardial instillation seems to be longer than that of the remaining patients.