Cardiac tamponade due to metastasis from early gastric cancer |
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Authors: | Ichiro Akagi Masao Miyashita Masayoshi Hashimoto Hiroshi Makino Tsutomu Nomura Keiichi Ohkawa Yoshikazu Tsuchiya Takashi Tajiri |
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Institution: | (1) Division of Gastroenterology, General, Breast and Transplant, Department of Surgery for Organ Function and Biological Regulation, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan;(2) Department of Surgery, Mitsubishi Ohkurayama Hospital, Kanagawa, Japan |
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Abstract: | We report a case of cardiac tamponade caused by metastasis from early gastric cancer. A 44-year-old woman was detected to
have an abnormality of the stomach on barium meal during an annual medical checkup. Gastroendoscopy disclosed superficial
depressed gastric lesions, and histopathological examination of biopsy specimens revealed the diagnosis of poorly differentiated
adenocarcinoma and signet-ring cell carcinoma. Computed tomography (CT) and ultrasonography (US) revealed no evidence of metastasis.
We performed distal gastrectomy with regional lymph node dissection. Histopathological examination revealed poorly differentiated
adenocarcinoma and signet-ring cell carcinoma confined to the mucosal layer. Lymphatic invasion was detected only in the mucosal
region beneath the tumor; however, lymph node metastasis was found in almost half of dissected lymph nodes. Adjuvant chemotherapy
was administered on an outpatient basis with 36 courses of mitomycinC infused (8 mg/day) once every 4 weeks. However, 3 years
after the surgery, the patient developed cardiac tamponade due to carcinomatous pericarditis. We performed drainage of the
malignant effusion and initiated treatment with S-1 and docetaxel. Although the patient showed some clinical improvement,
the patient died 15 months after the occurrence of cardiac tamponade. |
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Keywords: | Cardiac tamponade Early gastric cancer Pericardial effusion Metastasis |
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