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Malignant Pericardial Effusion from Cervical Squamous Cell Carcinoma: A Case Study.

Sunder Sham¹, Saroja Devi Geetha², Alae Kawam³

¹Department of Pathology and Laboratory Medicine, Northwell, Health Lenox Hill Hospital, New York City, NY, USA.

The American Journal of Case Reports

|August 28, 2024

Summary

Metastasis of cervical squamous cell carcinoma to the pericardium is rare. This case highlights the importance of considering pericardial fluid cytology for diagnosing rare metastatic sites in cancer patients.

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Area of Science:

Oncology
Pathology
Cytology

Background:

Cervical cancer is a leading global cancer in women, with squamous cell carcinoma being the most common histologic type.
Common sites of metastasis include lungs and paraaortic nodes; however, uncommon sites like the pericardium are rarely reported.
Pericardial effusion is a significant clinical finding that warrants thorough investigation for underlying malignancy.

Observation:

A 42-year-old woman with a history of stage III cervical squamous cell carcinoma presented with symptoms suggestive of pericardial effusion and metastatic disease.
Clinical workup confirmed pericardial effusion with spread to lungs and lymph nodes.
Cytological analysis of pericardial fluid revealed malignant squamous cells, confirmed by immunohistochemistry (p63+, p40+).

Findings:

The cytologic diagnosis of metastatic squamous cell carcinoma to the pericardial fluid was established.
Immunohistochemistry markers supported the diagnosis and helped exclude other potential primary sites.
The findings underscore the possibility of rare metastatic patterns in advanced cervical cancer.

Implications:

Malignant pericardial effusions can arise from uncommon primary sites, including cervical cancer.
Cytological evaluation of pericardial fluid is crucial for diagnosing metastatic disease, especially in patients with a history of cancer.
Clinicians should consider metastatic cervical cancer in the differential diagnosis of unexplained pericardial effusions in female patients, particularly those with high-grade tumors or recurrent disease.