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Report of a Rare Case of Primary Pericardial Malignancy
T O Folorunso1,2, E A Adedeji3, A E Folorunso1
1Oluwarotimi Specialist and Diagnostic Centre, Akure, Ondo State, Nigeria.
Background:
Primary pericardial malignancy is rare and often clinically silent until the late stage when survival is abysmally poor.
Objectives:
To emphasize the need for a high index of suspicion and accessibility as well as affordability of cardiac magnetic resonance imaging in our clinical practice.
Case Report:
68years old male sawmiller who presented with a history of progressive weight loss and recurrent fever and 3 months history of generalized body swelling and dyspnea. Examination revealed an elderly man, wasted with cold clammy extremities and anasarca, Blood pressure was 100/60mmHg, elevated JVP, and distant heart sound S1, S2, S3. Grossly distended abdomen but no palpable organomegaly and ascites demonstrable by fluid thrill. Tachypnea with dull percussion note with reduced tactile fremitus and breath sound bilaterally. A plain chest radiograph revealed cardiomegaly while electrocardiography revealed ventricular tachycardia. The diagnosis was confirmed by both echocardiography and computerized tomography which revealed a circumferential pericardial mass. The patient's response to treatment was poor and died 9th day of admission.
Conclusion:
There is a need for a high index of suspicion, accessible and affordable cardiac resonance imaging for accurate and prompt diagnosis of rare condition.
Insights
Primary pericardial malignancy is rare and deadly, often presenting late. Early suspicion and accessible cardiac MRI are crucial for timely diagnosis and improved outcomes in these challenging cases.
Area of Science:
- Cardiology
- Oncology
- Radiology
Background:
- Primary pericardial malignancy is an exceptionally rare condition.
- It often remains clinically silent until advanced stages, leading to poor prognoses.
Observation:
- A 68-year-old male presented with progressive weight loss, recurrent fever, generalized swelling, and dyspnea.
- Clinical examination revealed signs of severe systemic illness, including hypotension, elevated JVP, and anasarca.
- Diagnostic imaging, including echocardiography and CT, confirmed a circumferential pericardial mass.
Findings:
- The patient exhibited cardiomegaly on chest X-ray and ventricular tachycardia on ECG.
- Despite diagnostic confirmation, the patient's response to treatment was poor, and he died shortly after admission.
- The case highlights the diagnostic challenges and poor prognosis associated with primary pericardial malignancy.
Implications:
- Emphasizes the critical need for a high index of suspicion for primary pericardial malignancy.
- Stresses the importance of accessible and affordable cardiac magnetic resonance imaging (CMR) for prompt and accurate diagnosis.
- Underscores the potential for improved patient outcomes with earlier detection through advanced imaging modalities.
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