Demonstration of unsuspected malignant disease of the pericardium by computed tomography

Massive pericardial effusion associated with mediastinal neoplasm was first diagnosed by findings at computed tomography (CT) in two patients. In each case the CT findings prompted urgent pericardiocentesis for relief of pericardial tamponade. One of the patients was subsequently found to have a widely disseminated renal papillary adenocarcinoma, and the other had fibrosarcomatous mesothelioma of the pericardium. The role of CT in the diagnosis of pericardial disease is discussed.