The following is a summary of “Pericardial Effusion in Oncological Patients: Current Knowledge and Principles of Management,” published in the February 2024 issue of Oncology by Mori al.
Pericardial effusion is a common occurrence in oncological patients, often diagnosed incidentally or through imaging techniques like transthoracic echocardiography (TTE) and computed tomography (CT). This review aims to provide healthcare professionals with current insights into the causes, manifestations, and management of pericardial effusion in cancer patients. Additionally, it addresses the pertinent question of when malignancy should be suspected in cases of newly diagnosed pericardial effusion without a prior cancer diagnosis.
Cancer-related pericardial effusion typically arises from the infiltration of lung and breast cancer, melanoma, or lymphoma into the pericardium via various routes. Additionally, cancer therapies, including radiation therapy and immune checkpoint inhibitors, may induce pericardial effusion, either acutely or delayed. Drainage procedures, such as pericardiocentesis, are crucial for managing pericardial effusion-induced hemodynamic compromise, with temporary catheter placement recommended post-drainage. Conversely, conservative management is advocated for stable patients with large effusions, although optimal monitoring strategies remain uncertain. Immune checkpoint inhibitor-induced effusions often respond to corticosteroid therapy, while cytological examination of pericardial fluid may confirm neoplastic involvement but yields low sensitivity. In cases of newly detected pericardial effusion without a recent cancer history, clinical indicators such as recurrent effusion, incomplete response to standard therapy, or hemorrhagic fluid suggest a neoplastic etiology warranting further investigation.
Pericardial effusion in oncological patients presents a multifaceted challenge, demanding nuanced management strategies based on etiology and clinical presentation. This review underscores the importance of recognizing malignancy as a potential cause of pericardial effusion, particularly in specific clinical scenarios, to ensure timely and appropriate intervention.
Source: cardiooncologyjournal.biomedcentral.com/articles/10.1186/s40959-024-00207-3
