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Summary
Malignant pericardial effusions can indicate lung cancer, even without a visible lung mass. Adenocarcinoma diagnosis was confirmed through fluid cytology and elevated carcinoembryonic antigen levels in two patients.
Area of Science:
- Oncology
- Cardiology
- Pulmonary Medicine
Background:
- Malignant pericardial effusion is a rare initial presentation of cancer.
- Lung adenocarcinoma is the most common cause of malignant pericardial effusion.
Observation:
- Two cases of cardiac tamponade secondary to adenocarcinoma of the lung are presented.
- One patient presented with cardiac tamponade, while the other had prior cutaneous involvement.
- Cytologic and ultrastructural examination of pericardial fluid confirmed adenocarcinoma.
Findings:
- Computed tomographic (CT) scans showed mediastinal fullness without lung involvement in both patients.
- Elevated carcinoembryonic antigen (CEA) levels were detected in the pericardial fluid.
- Diagnosis included poorly differentiated adenocarcinoma and bronchioloalveolar carcinoma.
Implications:
- Lung carcinoma should be suspected in patients with malignant pericardial effusions, even without evident pulmonary masses.
- Early diagnosis and treatment are crucial for improving patient outcomes.
- This highlights the importance of thorough diagnostic workup for unexplained pericardial effusions.