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Open AccessCase Report
J. Clin. Med. 2015, 4(1), 75-84; doi:10.3390/jcm4010075

Malignant Cardiac Tamponade from Non-Small Cell Lung Cancer: Case Series from the Era of Molecular Targeted Therapy

1
Department of Medical Oncology, Royal North Shore Hospital, St. Leonards, NSW 2065, Sydney, Australia
2
Sydney Medical School, University of Sydney, NSW 2006, Sydney, Australia
3
Department of Cardiothoracic Surgery, Royal North Shore Hospital, St. Leonards, NSW 2065, Sydney, Australia
*
Author to whom correspondence should be addressed.
Academic Editor: Paul Huang
Received: 3 September 2014 / Accepted: 16 December 2014 / Published: 30 December 2014
View Full-Text   |   Download PDF [565 KB, uploaded 30 December 2014]   |  

Abstract

Cardiac tamponade complicating malignant pericardial effusion from non-small cell lung cancer (NSCLC) is generally associated with extremely poor prognosis. With improved systemic chemotherapy and molecular targeted therapy for NSCLC in recent years, the prognosis of such patients and the value of invasive cardiothoracic surgery in this setting have not been adequately examined. We report outcomes from a contemporary case series of eight patients who presented with malignant cardiac tamponade due to NSCLC to an Australian academic medical institution over an 18 months period. Two cases of cardiac tamponade were de novo presentations of NSCLC and six cases were presentations following previous therapy for NSCLC. The median survival was 4.5 months with a range between 9 days to alive beyond 17 months. The two longest survivors are still receiving active therapy at 17 and 15 months after invasive surgical pericardial window respectively. One survivor had a histological subtype of large cell neuroendocrine carcinoma and the other received targeted therapy for epidermal growth factor receptor mutation. These results support the consideration of active surgical palliation to treating this oncological emergency complicating NSCLC, including the use of urgent drainage, surgical creation of pericardial window followed by appropriate systemic therapy in suitably fit patients. View Full-Text
Keywords: lung cancer; cardiac metastasis; pericardial effusion; pericardial window techniques; pericardiocentesis; chemotherapy; palliative therapy lung cancer; cardiac metastasis; pericardial effusion; pericardial window techniques; pericardiocentesis; chemotherapy; palliative therapy
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Li, B.T.; Pearson, A.; Pavlakis, N.; Bell, D.; Lee, A.; Chan, D.; Harden, M.; Mathur, M.; Marshman, D.; Brady, P.; Clarke, S. Malignant Cardiac Tamponade from Non-Small Cell Lung Cancer: Case Series from the Era of Molecular Targeted Therapy. J. Clin. Med. 2015, 4, 75-84.

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