Intrapericardial Cisplatin Combined with Oral Colchicine Resulting in Long Term Control of Malignant Pericardial Effusion in the Course of Metastatic Renal Cancer

Introduction: Neoplastic pericardial effusion (NPE) represents a common cause of morbidity and mortality in patients with cancer. NPE presents frequently as cardiac tamponade, requiring urgent pericardiocentesis or pericardiotomy, with subsequent pericardial fluid drainage. Despite high effectiveness of such procedures, the recurrence of effusion is noted in 30–60% of patients. Intrapericardial therapy with cisplatin was found to be effective in NPE due to lung and breast cancer. Its role in cardiac tamponade due to renal cancer is unknown. Case presentation: We presented an 82-year-old man with renal cancer who was admitted to the Intensive Care Unit because of threatening pericardial tamponade due to NPE. Urgent subxiphoid pericardiotomy was performed with subsequent evacuation of 1000 ml of bloody fluid. On the inner surface of the pericardium, several pink nodules were found. Histological examination revealed carcinoma clarocellulare. In view of the persistent high drainage of the pericardium, intrapericardial cisplatin therapy was performed. On the first day after surgery, colchicine 0.5 mg/day/po was also introduced. No side effects of the treatment were observed. The patient died 12 months later due to cancer progression and cachexia. No recurrence of pericardial effusion was observed. Conclusion: This is the first case study demonstrating long-term efficacy and safety of intrapericardial cisplatin combined with oral colchicine in NPE due to metastatic renal cell carcinoma.