Bilious pericardial effusion at initial presentation in a patient with lung cancer

World Journal of Surgical Oncology

Marios Konstantinou¹  Konstantinos Kostikas¹  Konstantinos Letsas²  Christophoros Foroulis¹  Christophoros S Kotoulas² 

[1] 2nd Thoracic Surgery Department, Chest Diseases Hospital of Athens, Mesogeion 152, GR-115 27 Athens, Greece;Thoracic Surgery Department, 401 General Military Hospital of Athens, 138 Mesogeion Ave & Katechaki str, GR-115 10 Athens, Greece

关键词: pericardio-biliary fistula;    lung cancer;    hydatid disease;    cardiac tamponade;    pericardial effusion;    Bile;   

Others  :  1207497
DOI  :  10.1186/1477-7819-1-24

 received in 2003-07-20, accepted in 2003-11-08,  发布年份 2003

【 摘 要 】

Background

Cardiac tamponade as the initial manifestation of metastatic cancer is a rare clinical entity. Furthermore, a thoraco-biliary fistula is another rare complication of echinococcosis due to rupture of hydatid cysts located at the upper surface of the liver to the pleural or pericardial cavity. We report a case of non-small cell lung cancer with a coexisting hepatic hydatid cyst presenting as a bilious pericardial effusion.

Case report

A 66-year-old patient presented with cardiac tamponade of unknown origin. Chest CT-scan demonstrated a left central lung tumor, a smaller peripheral one, bilateral pleural effusions and a hydatid cyst on the dome of the liver in close contact to the diaphragm and pericardium. Pericardiotomy with drainage was performed, followed by bleomycin pleurodesis. The possible mechanism for the bilious pericardial effusion might be the presence of a pericardio-biliary fistula created by the hepatic hydatid cyst.

Conclusions

This is the first case of a bilious pericardial effusion at initial presentation in a patient with lung cancer with coexisting hepatic hydatid cyst.

【 授权许可】

   
2003 Kotoulas et al; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.

【 图 表 】

Figure 1.

Figure 2.

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