Palliative Pericardiectomy for Constrictive Pericarditis Caused by Squamous Cell Carcinoma of the Breast: A Case...

Constrictive pericarditis caused by malignancy is a rare but serious condition, with limited reports on its palliative surgical management. In particular, pericardial metastasis from squamous cell carcinoma of the breast is extremely uncommon, and the role of pericardiectomy in such cases remains unclear. A 57-year-old woman underwent a left mastectomy for squamous cell carcinoma of the breast at the age of 54 years. Two years later, the patient developed cardiac tamponade and underwent pericardiocentesis. Cytological examination confirmed malignant pericarditis due to recurrent breast cancer. Although partial remission was achieved with chemotherapy, the patient subsequently developed heart failure symptoms, making it difficult to continue the chemotherapy. Echocardiography and chest computed tomography revealed pericardial thickening, whereas the right heart catheterization showed a dip-and-plateau waveform, leading to a diagnosis of constrictive pericarditis. Given that prolonged survival for several years was expected with continued chemotherapy, pericardiectomy was performed. Postoperative pathological examination confirmed pericardial metastasis of breast cancer. Although the patient experienced temporary symptomatic improvement postoperatively, her condition worsened, leading to death on postoperative day 28. This case suggests that even when palliative pericardiectomy is performed for malignant constrictive pericarditis, the prognosis may remain poor owing to progressive heart failure. In particular, postoperative left ventricular dysfunction and cancer cachexia can significantly affect outcomes, necessitating careful consideration of surgical indications.