Malignant Pericardial Disease

摘要: Metastases to the pericardium are far more common than primary tumors. Tumor may involve by one of three pathways: retrograde lymphatic extension, hematogenous spread, or direct contiguous extension. The predominant route is spread through channels in mediastinum heart, producing small tumor implants on epicardial surface heart. For most cancers, involvement indicates distant metastases, M1 disease. presence a malignant pericardial effusion associated with poor prognosis, survival times less year cases. clinical presentation variable, majority patients presenting gradual onset dyspnea and chest pain rather acute tamponade. Malignant tamponade implies prognosis median 150 days. In patient known malignancy, finding should prompt further investigation. be related previous treatment, including both radiation therapy chemotherapy, infection inflammation, occur as result local invasion, tumor. Relief symptoms achieved pericardiocentesis, creation window. A combination systemic offer benefit some patients.