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“A double twist” presentation – a case report of purulent cardiac tamponade following a rare complication of small-cell lung cancer radiotherapy

2024-04-23Journal article Open access
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dc.contributor.authorFeijó, Salvato
dc.contributor.authorMorais, João
dc.contributor.authorSaraiva, Fátima
dc.contributor.authorSilva, Sónia
dc.contributor.authorCabral, Margarida
dc.contributor.authorMiguel Gonçalves, Carolina
dc.contributor.authorAmorim, Diana
dc.date.accessioned2024-09-04T13:05:27Z
dc.date.available2024-09-04T13:05:27Z
dc.date.issued2024-04-23
dc.description.abstractBackground: Small cell lung cancer is an aggressive tumor with a poor prognosis that requires prompt treatment. While radiotherapy may enhance survival when superior vena cava syndrome is present, radiation therapy–induced pericardial disease can be a potential complication. Case Report: A 55-year-old man, who recently underwent radiotherapy for stage IV small-cell lung cancer complicated by superior vena cava syndrome, presented with chest pain and dyspnea. In the emergency room, he was dyspneic, hypotensive, and tachycardic. Pulmonary auscultation revealed the absence of lung sounds on the right. The initial electrocardiogram showed ST-segment elevation in lateral leads and in lead DII, with reciprocal changes in lead DIII. A bedside transthoracic echocardiogram revealed cardiac tamponade and emergent pericardiocentesis was performed, removing 500 ml of purulent fluid, resulting in an immediate clinical improvement. Thoracentesis was also performed, showing no empyema. Large spectrum empirical antibiotic therapy was started. Cultures from the pericardial fluid and peripheral blood grew multi-sensitive Streptococcus pneumoniae. Cytological analysis of the pericardial fluid was consistent with infection. The patient improved after 2 weeks of targeted antibiotic therapy and underwent the first cycle of chemotherapy. He was discharged with an early scheduled pulmonology appointment. Conclusions: Although the most common causes of pericardial effusion in lung cancer are malignant, non-malignant etiologies should also be considered. This patient had an infectious pericardial effusion most probably due to a pericardial-mediastinal mass fistula caused by radiotherapy. This was a diagnostic challenge, both in the emergency room as well in the inpatient setting.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationAmorim D, Gonçalves CM, Cabral M, Silva S, Saraiva F, Morai J, Feijó S. “A double twist” presentation – a case report of purulent cardiac tamponade following a rare complication of small-cell lung cancer radiotherapy. EJCRIM 2024;11:doi:10.12890/2024_004477pt_PT
dc.identifier.doihttps://doi.org/10.12890/2024_004477pt_PT
dc.identifier.issn2284-2594
dc.identifier.urihttp://hdl.handle.net/10400.8/9999
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSMC media Srlpt_PT
dc.relation.publisherversionhttps://www.ejcrim.com/index.php/EJCRIM/article/view/4477pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectSmall cell lung cancerpt_PT
dc.subjectSTEMIpt_PT
dc.subjectCardiac tamponadept_PT
dc.subjectDifferential diagnosispt_PT
dc.subjectRadiotherapypt_PT
dc.title“A double twist” presentation – a case report of purulent cardiac tamponade following a rare complication of small-cell lung cancer radiotherapypt_PT
dc.title.alternativeDiana Amorim1*, Carolina Miguel Gonçalves2*, Margarida Cabral2, Sónia Silva1,3, Fátima Saraiva2, João Morais2,3, Salvato Feijó1pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue6pt_PT
oaire.citation.titleEuropean Journal of Case Reports in Internal Medicinept_PT
oaire.citation.volume11pt_PT
person.familyNameMorais
person.familyNameSilva
person.givenNameJoão
person.givenNameSónia
person.identifier.ciencia-id3614-652A-118E
person.identifier.orcid0000-0003-3406-2878
person.identifier.orcid0000-0002-3655-5580
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication3bc0f910-a460-461f-863a-1ca701ee597f
relation.isAuthorOfPublication49fad517-c54e-4d78-81ed-b87bf8ab4d21
relation.isAuthorOfPublication.latestForDiscovery3bc0f910-a460-461f-863a-1ca701ee597f

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