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Managing malignant pericardial effusion.

A C Buzaid, H S Garewal, B R Greenberg

    The Western Journal of Medicine
    |February 1, 1989
    PubMed
    Summary
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    Metastatic tumors frequently involve the pericardium, leading to malignant pericardial effusion. Treatment depends on prognosis and tumor characteristics, aiming for palliation despite the condition usually being incurable.

    Area of Science:

    • Oncology
    • Cardiology
    • Pathology

    Background:

    • Metastatic tumors commonly affect the pericardium, especially in lung cancer, breast cancer, lymphomas, leukemias, and melanomas.
    • Malignant pericardial effusion is a significant complication in these patient populations.

    Purpose of the Study:

    • To outline the therapeutic modalities for malignant pericardial effusion.
    • To discuss factors influencing treatment selection and patient prognosis.

    Main Methods:

    • Review of established therapeutic options for malignant pericardial effusion.
    • Analysis of factors guiding optimal treatment strategies.

    Main Results:

    • Five primary treatment modalities exist: pericardiocentesis, pericardial sclerosis, systemic chemotherapy, radiotherapy, and surgery.

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  • Treatment choice hinges on life expectancy, tumorchemotherapy/irradiation responsiveness, and presence of cardiac tamponade.
  • Prognosis is dictated by the extent and histology of the primary cancer.

    • Conclusions:

    • Malignant pericardial effusion is typically incurable.
    • Effective palliation and a reasonable quality of life can be achieved for most patients.
    • Personalized treatment strategies are crucial for managing this condition.