Malignant Pericardial Tamponade Secondary to Ovarian Clear Cell Carcinoma

Mayumi Sawada, Sawada M, Tetsuro Oishi, Oishi T, Michiko Nonaka, Nonaka M, Kohei Hikino, Hikino K, Masayo Ookawa, Ookawa M, Yuki Iida, Iida Y, Masayo Hosokawa, Hosokawa M, Hiroaki Komatsu, Komatsu H, Kudoh A, Akiko Kudoh, Sato S, Shinya Sato, Taniguchi F, Fuminori Taniguchi
Yonago acta medica · 2023 · vol. 66(4) , pp. 459–462 · doi:10.33160/yam.2023.11.004 · PMID:38028261 · PMC10674060
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A 46-year-old woman with recurrent ovarian clear cell carcinoma developed malignant pericardial tamponade, where cytological analysis of pericardial fluid successfully identified metastatic disease.

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This case report describes a 46-year-old woman with recurrent ovarian clear cell carcinoma who developed malignant pericardial tamponade, presenting with respiratory distress and palpitations during chemotherapy. Diagnostic imaging confirmed pleural effusion and cardiac tamponade, while cytological analysis of the drained pericardial fluid revealed malignant cells with distinct morphological features consistent with metastatic clear cell carcinoma. The patient underwent pericardial fenestration for palliative relief and subsequently received palliative care, surviving five months post-procedure without recurrence of the tamponade. This paper is centrally about ovarian cancer complications; relevance to endometriosis: ovarian clear cell carcinoma is strongly associated with endometriosis, though this specific case focuses on metastatic cardiac involvement rather than the gynecological pathology itself.

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Abstract

Malignant pericardial effusion is an uncommon metastatic manifestation of ovarian carcinoma. Few cases of ovarian serous carcinoma have been previously reported. Ovarian clear cell carcinoma is the second most common histologic subtype in East Asian countries and is a relatively rare in Western countries. Here, we report the case of cardiac tamponade secondary to Ovarian clear cell carcinoma. A 46-year-old woman with recurrent Ovarian clear cell carcinoma presented with worsening cough, palpitations, and shortness of breath during chemotherapy. Chest radiography and computed tomography confirmed a pleural effusion with cardiac tamponade. The patient underwent pericardial fenestration and drainage for cardiac tamponade. Pericardial fluid cytology showed malignant cells forming papillary and ball-like clusters with irregular stacking. The cells had a mirror ball-like appearance and collagenous stroma, in which a homogenous hyaline core was observed in the center of most tumor cell clusters. Based on these findings, a diagnosis of Ovarian clear cell carcinoma metastasis was made. She received palliative care and died 5 months after the operation without recurrent cardiac tamponade. This case suggests that cytological findings from pericardial effusion are useful in diagnosing Ovarian clear cell carcinoma metastasis.
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Keywords

cardiac tamponade, clear cell carcinoma, cytology, ovarian carcinoma, pericardial effusion 2023 Volume 66 Issue 4 Pages 459-462 Details

Abstract

Malignant pericardial effusion is an uncommon metastatic manifestation of ovarian carcinoma. Few cases of ovarian serous carcinoma have been previously reported. Ovarian clear cell carcinoma is the second most common histologic subtype in East Asian countries and is a relatively rare in Western countries. Here, we report the case of cardiac tamponade secondary to Ovarian clear cell carcinoma. A 46-year-old woman with recurrent Ovarian clear cell carcinoma presented with worsening cough, palpitations, and shortness of breath during chemotherapy. Chest radiography and computed tomography confirmed a pleural effusion with cardiac tamponade. The patient underwent pericardial fenestration and drainage for cardiac tamponade. Pericardial fluid cytology showed malignant cells forming papillary and ball-like clusters with irregular stacking. The cells had a mirror ball-like appearance and collagenous stroma, in which a homogenous hyaline core was observed in the center of most tumor cell clusters. Based on these findings, a diagnosis of Ovarian clear cell carcinoma metastasis was made. She received palliative care and died 5 months after the operation without recurrent cardiac tamponade. This case suggests that cytological findings from pericardial effusion are useful in diagnosing Ovarian clear cell carcinoma metastasis. © 2023 Tottori University Medical Press Favorites & Alerts Recently viewed articles

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