J Cardiovasc Ultrasound.  2010 Sep;18(3):104-107. 10.4250/jcu.2010.18.3.104.

A Rare Case with Primary Undifferentiated Carcinoma of Pericardium

• Kwon HY
• Cho KI
• Kim SM
• Lee HG
• Hwang CS
• Kim HJ
• Kang JH
• Kim MJ
• Jang KT
• Kim TI

• KMID: 2177309
• DOI: http://doi.org/10.4250/jcu.2010.18.3.104

Abstract

A primary pericardial tumor is very rare. A 77-year-old woman was admitted to our hospital with chief complaint of exertional dyspnea due to large amount of pericardial effusion. She was finally diagnosed as pericardial undifferentiated carcinoma without definite histopathologial, immunochemistry feature. Despite palliative radiation therapy, the patient died of multiple organ failure. The prognosis of primary pericardial undifferentiated carcinoma is known to be very poor, especially in old people.

Keyword

Primary pericardial tumor; Pericardial effusion; Echocardiography; Undifferentiated carcinoma

MeSH Terms

Aged
Carcinoma
Dyspnea
Echocardiography
Female
Humans
Immunochemistry
Multiple Organ Failure
Pericardial Effusion
Pericardium
Prognosis

Figure

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  Fig. 1 Transthoracic echocardiography (A: parasternal long axis view, and B: parasternal short axis view) revealed large amount circumferential pericardial effusion (arrows). Contrast-enhanced computed tomography (C) showed a large pericardial effusion with mass (15 mm in thickness over the right ventricle and 25 mm over the left ventricle), located in transverse sinus between large vessels and upper portion of the left atrium.

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  Fig. 2 Transthoracic echocardiography (A: parasternal long axis view, and B: parasternal short axis view) revealed a mass (arrows) of inhomogenous echogenecity, located in juxtaaortic valve area. Contrast-enhanced chest CT (C) showed a large soft tissue mass about 3.7×9.5 cm-sized, located in transverse sinus between large vessels and upper portion of the left atrium (arrows).

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  Fig. 3 Follow-up T2-weighted MR image after 3 month of initial presentation showed that a huge mass (arrows) about 8×15 cm-sized, settled in transverse sinus was compressing right superior vena cava without evidence of invasion of adjacent vessels.

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  Fig. 4 The tumor cells revealed pleomorphic and hyperchromatic nucleus with epithelioid feature without any definite differentiation (H&E, ×400).

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  Fig. 5 In immunohistochemical study, tumor cells showed positive reactivity for EMA (A), CK (B), vimentin (C), and CD99 (D). EMA: epithelial membrane antigen, CK: cytokeratin.

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  Fig. 6 Follow-up transthoracic echocardiography after 4 month of initial presentation revealed an increased huge mass (arrows) of inhomogenous echogenecity that was located in juxtaaortic valve area.

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