2020 Volume 53 Issue 5 Pages 456-462
A 65-year-old woman underwent laparoscopic anterior resection for rectal cancer in December 2013 and received adjuvant chemotherapy because it was pStage IIIb. She underwent thoracoscopic partial lung resection for lung metastasis in September 2015. One year later, mediastinal lymph node metastasis was noted and chemotherapy was started. In November 2018, she complained of dyspnea and exertional shortness of breath due to cardiac tamponade and underwent pericardial drainage. The cytology showed adenocarcinoma, therefore it was diagnosed as pericardial metastasis of primary rectal cancer. After being discharged, chemotherapy was restarted. In March 2019, she had loss of appetite and re-accumulation of pericardial effusion. Pericardial drainage was performed due to recurrence of cardiac tamponade. Her symptoms disappeared with drainage but she passed away on the 21st day after being admitted. Cardiac metastasis of gastrointestinal cancer is uncommon and pericardial metastasis of rectal cancer is very rare. It is presumed that lymphogenous metastasis is a major mechanism of pericardial metastasis. In cases like ours, where a patient has mediastinal lymph node metastasis, the possibility of cardiac tamponade should be considered.
