[Cardiac tamponade as the first manifestation of cancer]

We report 3 patients having cardiac tamponade as the initial presentation of cancer. At the onset of symptoms all three patients were incorrectly diagnosed. Pulsus paradoxus and cardiomegaly on the Chest X-Ray were the main clinical features. Two dimensional echocardiography was vital revealing massive pericardial effusion with diastolic right atrial and ventricular collapse. All patients had bloody pericardial fluid removed and the histopathology of the metastatic pericardial tissue showed lung cancer, thymoma and lymphoma.