A Case of Carcinomatosa Pericarditis from Gastric Cancer with Cardiac Tamponade Eight Years after a Surgical Treatment

Joe Sakurai, Takeharu Enomoto, Kouhei Segami, Akiyoshi Noda, Masafumi Katayama, Toshiyuki Suwa, Shinjirou Kobayashi, Hiroshi Nakano, Ichiro Tanaka and Takehito Otsubo

Department of Gastroenterological and General Surgery, St. Marianna University School of Medicine

A 55-year-old man who had undergone total gastrectomy, splenectomy, and cholecystectomy for Borrmann 4 type gastric cancer in October 1994 reported appetite loss, leg edema, and coughing. He became aware of these symptoms in February 2002 and underwent examination in March 2002. Ultrasonographic echocardiography showed massive pericardial effusion with right ventricular collapse with cardiac tamponade diagnosed due to carcinomatous pericarditis. Cytologyical examination of the pericardial and plural effusion showed class V signet ring cell carcinoma whole-body bone scintigraphy showed multiple bone metastases. TS-1 was orally administered for four weeks per os, with a two-week rest interval. Cytological evaluation of pericardial and plural effusion was negative after only one course of chemotherapy. Bone metastases were also dramatically reduced. The man died of rapid respiratory failure with pulmonary lymphangitis 229 days after the start of the three chemotherapeutic courses. TS-1 is considered useful in managing malignant pericardial effusion. I thought that I should have considered TS-1 as alternatives of a treatment because TS-1 was effective for carcinomatous pericarditis.

Key words
pericardial metastasis, cardiac tamponade, gastric cancer

Reprint requests
Joe Sakurai Department of Gastroenterological and General Surgery, St. Marianna University School of Medicine
2-16-1 Sugao, Miyamae-ku, Kawasaki, 216-8511 JAPAN

Accepted
May 21, 2008

To read the PDF file you will need Abobe Reader installed on your computer.