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

BACKGROUND Cervical cancer ranks fourth globally among women's cancers. Squamous cell carcinoma constitutes 70% of cervical cancer cases, often metastasizing to lungs and paraaortic nodes. Uncommon sites include the brain, skin, spleen, and muscle, while pericardial fluid metastasis is highly rare. We report a case of squamous cell carcinoma of the uterine cervix that was metastatic to the pericardium and was detected on cytologic evaluation of pericardial fluid. CASE REPORT A 42-year-old woman who was previously treated for stage III squamous cell carcinoma of the cervix presented with symptoms of cough, fever, and shortness of breath for 8 days, and chest pain for 3 days. Clinical workup revealed pericardial effusion, with spread to the lungs and mediastinal and hilar lymph nodes. Cytological analysis of the fluid showed malignant cells, consistent with metastatic squamous cell carcinoma. Immunohistochemistry demonstrated cells positive for p63 and p40, while negative for GATA-3, D2-40, calretinin, and WT1. These findings in conjunction with patient's known history of cervical squamous cell carcinoma was consistent with a cytologic diagnosis of metastatic squamous cell carcinoma to pericardial fluid. CONCLUSIONS History and clinical correlation plays a vital role in determining the primary site causing malignant pericardial effusions. While the occurrence of cervical cancer metastasizing to the pericardium is uncommon, it should be considered, particularly in cases involving high-grade, invasive tumors, recurrences, or distant metastases. This possibility should be included in the list of potential diagnoses when encountering pericardial effusions with squamous cells in female patients.