Pericardial tamponade as the first manifestation of adenocarcinoma

We hereby report on 13 cases of pericardial tamponade as the first manifestation of an adenocarcinoma. The primary tumor was detected in 10 cases: 7 lung, 1 stomach, 1 breast and 1 thyroid. A first cytologic examination of the pericardial fluid yielded the diagnosis of adenocarcinoma in 10 cases, whereas a second cytology was needed in another two cases. The pericardial biopsy was positive in 7 out of 7 patients. The therapeutic procedures included pericardiocentesis in 9 patients (6 of whom had recurrent tamponade), a pericardial window in 4 and pericardiotomy in 4 (without recurrences). The mean survival was 4 months.