Echocardiography showed a large pericardial effusion and early tamponade. There were also mass lesions in the mediastinum, lung, liver and bone. No metastatic tumor could be demonstrated in the pathologic specimens. Probably the most common non-neoplastic etiology is associated with radiation therapy. These patients can have long term survival after pericardiectomy.l Malignant pericardial effusion is usually associated with metastasis to mediastinal lymph nodes and therefore the most common neoplasms causing effusion are lung, breast, lymphoma, leukemia and melanoma in that approximate order.
Effusion usually occurs in a patient with advanced malignancy clinically apparent.
It can occasionally represent the initial presentation of a malignancy. It is difficult to make definitive statements about treatment of malignant pericardial effusions. There are only a few series with large enough numbers to approach statistical significance. No series of cases with proper experimental controls exists. Comparison of different series can be difficult because there is so much variation in prognosis depending on the cell type of the primary and on the stage of the tumor as well as the general health of the patients.