[Pericardial metastasis of lung cancer--report of 13 cases]

162 patients with lung cancer treated in our hospital from 1974 to 1986 are reported. Of these patients, thirteen had pericardial metastasis. There were 9 males and 4 females. The ages ranged from 32 to 73 years with an average of 54. The pericardial metastasis was diagnosed when the patients had pericardial friction sound, hydropericardium with or without malignant cells. Five of them had the above manifestations after lung cancers were confirmed. Four had large amount of hydropericardium, two had pericardial friction sound, and two had hydropericardium accompanied with thorax dropsy as initial presentation. Pathologically, the primary lung cancers were adenocarcinoma (7 cases), squamous cell carcinoma (4 cases) and small cell anaplastic carcinoma (2 cases). Cancer cells were found in 8 of 9 patients with hydropericardium (4 adenocarcinomas, 2 squamous cell carcinomas and 2 untyped carcinomas). It was believed that heart metastasis was rare, but 43.9-58.4% of the patients were found to have heart metastasis by autopsy and pericardium involvement was common. The incidence of pericardial metastasis was 8% in this series. This results accorded with the literatures reported. The data showed that pericardial metastasis is often misdiagnosed if hydropericardium with thorax dropsy appeared initially. It should be emphasized that repeated examination for malignant cells in "single" hydropericardium, especially for those being rapidly accumulated, is crucial for correct diagnosis.