Abstract
Metastatic head and neck squamous cell carcinoma (HNSCC) is a rare cause of cardiac tamponade. We report on a 62-year-old male who presented with metastatic squamous cell carcinoma (SCC) that caused cardiac tamponade secondary to a primary SCC originating from the retromolar trigone of the oral cavity. The clinical diagnosis was confirmed by physical examination, echocardiography and complete resolution of symptoms after pericardial fluid drainage. Cytologic examination of the pericardial fluid was the only investigational tool able to render a definitive evidence of malignant pericardial effusion. However, evidence of a hemorrhagic pericardial effusion must raise the suspicion of a malignant etiology regardless of the result of the cytologic examination. Metastatic HNSCC may involve multiple organ systems including the heart. We report this rare clinical presentation of cardiac tamponade as the initial location of distant metastasis. Otolaryngologists should keep a high index of suspicion and pay special attention to the symptoms arising on the non-head and neck sites to establish an early diagnosis and prompt management of the disease process.
References
Roy CL, Minor MA, Brookhart MA, Choudhry NK (2007) Does this patient with a pericardial effusion have cardiac tamponade? JAMA 297:1810–1818
Posner MR, Cohen GI, Skarin AT (1981) Pericardial disease in patients with cancer: the differentiation of malignant from idiopathic and radiation-induced pericarditis. Am J Med 71:407–413
Wang P-C, Yang K-Y, Chao J-Y et al (2000) Prognostic role of pericardial fluid cytology in cardiac tamponade associated with non-small cell lung cancer. Chest 118:744–749
Atar S, Chiu J, Forrester JS, Siegel RJ (1999) Bloody pericardial effusion in patients with cardiac tamponade. Chest 116:1564–1569
DeCamp MM Jr, Mentzer SJ, Swanson SJ, Sugarbaker DJ (1997) Malignant effusive disease of the pleura and pericardium. Chest 112:291s–295s
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Approval of the case study was obtained from the Institutional Review Board of the Chang Gung Memorial Hospital.
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Tsai, YT., Kuo, SW. & Hao, SP. Cardiac tamponade: a rare presentation from a rare metastatic site in oral squamous cell carcinoma. Eur Arch Otorhinolaryngol 267, 1483–1485 (2010). https://doi.org/10.1007/s00405-010-1304-1
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DOI: https://doi.org/10.1007/s00405-010-1304-1