RESUMO
In multiple myeloma the involvement of the pericardium is very rare and usually caused by amyloidosis, infections, bleeding abnormalities or plasma cell infiltration, usually at a late or terminal stage of the disease. Constructive pericarditis and massive pericardial effusion is a rare presentation in this disease. The clinical picture includes slowly progressing pericardial effusion as well as emergency pericardial temponade. Treatment typically consists of surgical management of the effusion by means of pericardial fenestration. Medical thoracoscopy is a non-invasive, simple procedure that gained popularity among interventional pulmologists and which has not been reported before in the management of multiple myeloma pericardial effusion. We present a male patient that was diagnosed with non-specific chronic pericarditis associated with massive pericardial effusion. This is the report of management of pericardial tamponade by means of thoracoscopic pericardial fenestration