1. Dmitrieva A.G
Burmasova A.V.
Zulfigarova B.T.
November 22, 2011

2. Tumor of pericardium is a rare and insufficiently
explored area in clinical oncology.
Pericardial tumor cases are complexified with a
variety of clinical patterns, difficulties in diagnosis
and absence of apparent symptoms of pathology.
The estimated frequency of pericardial tumor ranges
from 0,0017% to 0,02%.

3. Melanoma (4%)
Sarcoma (4%)
lungs (42%)
Breast
(22%)
Stomach
(3%)
Lymphoma
(15%)
Intestines
(3%)
Leukemia
(15%)

4. Not obvious and Pericarditis and
latent Heart Failure
Respiratory, Nerve
trunk, Bronchial tubes,
Esophagus, Heart and
Vassals compression

5. Increased
erythrocyte
Weight loss sedimentation more
 Low-grade than 30 mm / h
 Leukocytosis
fever  Increased
 Fatigue fibrinogen, haptoglob
Polyarthralgia in, gamma-
globulin, seromucoid,
 Cutaneous C-reactive protein
non-specific rash Hyperenzymemia
Hypercalcemia
Hyperkalemia
Anemia.

6. A 57-year- old female patient was treated from
respiratory infection that was complicated with
pneumonia in February of 2011 year.
After two weeks she noticed increased
dyspnea, tachycardia

7. In may, The patient presented in polyclinic with
complains of dyspnea, fatigue and cardiac
abnormalities
Echocardiography showed changes of pericardium.
Patient was hospitalized and treated with
diagnosis “Pericarditis of unknown etiology.
Atrial fibrillation”

8. • ESR – 35 mm/h
• Increased C-reactive
Full blood count protein, hyponatremia and
hypocalcemia
• Increased fibrinogen, alpha 2 -
globulin and beta-globulin.
•Atrial fibrillation
• 135 bpm heart rate
Electrocardiography • Deflection of the electrical axis of
the heart to the left
•QRS electrical alternant
•Diffuse myocardial changes of left
ventricle.

9. Normal left ventricular dimensions and systolic
function, compaction of walls of the aorta and
Echocardiography aortic valves, hyperechoic tumor mass in the
top of left ventricle. (Hydropericarditis )150 ml
of pericardial fluid

10. •Normal
Bronchoscopy • Atypical cells were not
found
Breast
ultrasound The cyst of left breast

11. The patient presented with complains of increased
dyspnea, fatigue and was hospitalized in
rheumatologic unit.
(Hemo-) Hydropercardit
Echocardiography 600 ml of pericardial fluid.
Risk of pericardial tamponade.
Cardiomegaly.
Elevated level cupula of left
Chest X-ray diaphragm.
Right pulmonary fibrosis.
Deformed hilar in both sides.

12. Drainage of the pericardium of the
right pleural cavity was done.
There were no signs of cancer in
cytological examinations.

13. Reduced volume of left lung.
Chest Computer Line fibrosis of inferior lobe
tomography scan of left lung.
with contrast Still present tumor mass in
the top of left ventricle.
Echocardiography Tumor mass in the top of left
ventricle also.
Chest x-ray Hydrothorax of left lob.

14. Examination showed presence of
epithelial malignant tumor

15. The patient was totally examined.
But location of primary tumor hadn’t been
found.
Diagnosis:
“Metastasis in pericardium from undetected
location TхNхM1”. Stage IV. 4 clinical group.
Germination in myocardium.”

16. • ESR – 25 mm/h
• Lymphopenia
•Increased C-reactive
Full blood count protein, hyponatremia and
hypocalcemia
• Increased fibrinogen, alpha 2 -
globulin and beta-globulin.
•Proteinuria
Urinalysis
• Hemoglobinuria
• Leukocyturia

17. Progressive
Echocardiography germination in
myocardium
Right lower lob
Chest X-ray
pneumonia
Lower third esophagus
Bronchoscopy
compression

18. The patient was places into the hospital on an
emergency basis with cardiac
decompensation

19. Hydropericarditis 200 ml
Echocardiography Tumor mass in the top of
left ventricle
Right lower lob
Chest X-ray
pneumonia Right
hydrothorax
Electrocardiography Sinus tachycardia

20. Ultrasound Fluid of Abdominal
cavity
MRI Mass of tumor
The primary tumor’s location was not
detected

21. Patient died of congestive heart failure despite
intensive treatment
Postmortem diagnosis:
Right bronchoalveolar lung cancer with
germination in mediastinum and pericardium
Metostasis in lymphatic nodes, рТ4рN2рМ2.

22. The lungs tumor was debuted with symptoms of
pericarditis, heart failure and arrhythmia.
For the first time, tumor of pericardium was
detected by Echocardiography.
MRI and CT presented just clinical findings of
line fibrosis and lower lob
pneumonia, examinations didn’t detect primary
tumor location.

23. Puncture of pericardium and Bronchoscopy with
bronchopulmonary lavage were not effective in
findings of primary tumor, atypical cells were not
found.
Epithelial malignant tumor was found only after
biopsy.
In case the biopsy in early stage had been
performed the tumor mass would have been
found on the stage where the immediate actions
would have been more successful .

24. Th a n k y o u f o r
y o u r
a t t e n t i o n !!!