Percutaneous Pericardiostomy and Trastuzumab Monotherapy for Treating Pericardial Metastasis from Breast Cancer and this Presented as Cardiac Tamponade

ABSTRACT

Although autopsy studies suggest that malignant pericardial effusion is present in up to 15% of the patients suffering with malignancies, symptomatic pericardial effusion presenting as a first manifestation of systemic recurrence in a breast cancer patient is a rare condition. Symptomatic malignant pericardial effusion requires prompt attention and intervention since it can lead to the cardiac tamponade. Treatment of symptomatic pericardial effusion includes pericardial decompression and systemic or intrapericardial chemotherapy. We recently experienced a patient with early breast cancer who developed cardiac tamponade from malignant pericardial effusion as a first manifestation of systemic recurrence 4 years after her initial surgery. The patient was treated with percutaneous pericardiocentesis and she subsequently received systemic trastuzumab. After 6 cycles of trastuzumab, the follow-up CT showed complete disappearance of the pericardial effusion and the mediastinal lymph nodes.