Vol.96 No.8 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 96 No.8 August 2003
A Case Report of Cardiac Tamponade from Primary Unknown
Cancer Effectively Treated with Intrapericardial Administration
of Antineoplastic Agents
Mariko Mori, Shuntaro Inagawa, Meiho Nakayama, Tatsuaki Sato, Noboru Matsumoto,
Tatsuyuki Banno, Shigeru Inafuku and Hiromichi Ishigami
(Aichi Medical University)
Cardiac tamponade caused by carcinomatous pericarditis is well known to be a common life-threatening complication of malignancy. However, it is uncommon to be found in neoplasm of the head and neck area. We herein report a case of cardiac tamponade as a complication of an unknown primary cancer with cervical metastasis.
A 62-year-old man, complaining of left neck swelling, visited us following the initial onset of this symptom. Squamous cell carcinoma was diagnosed from a neck biopsy, however, there was no evidence of abnormality in his laryngopharynx, nasal or oral cavities, thoracic or abdominal cavities as examined by CT, MRI, nuclear medicine and fiberscope. Chemotherapy using cisplatin and 5-fluorouracil was administered to this patient with an unknown primary cancer and cervical metastasis. His general condition gradually deteriorated after chemotherapy, and cardiac tamponade from pericarditis developed on the sixth day. The pericardial effusion was drained, and an examination found it to contain squamous cell carcinoma. After a direct administration of Mitomycin C injected into the pericardial cavity, the pericarditis improved. This treatment effectively improved the patient's condition and extended his life span while maintaining high QOL.
Key words : cardiac tamponade, primary unknown cancer, intrapericardial administration, neoplasm of the head and neck area