腎癌心膜転移による心タンポナーデをきたした1例

Abstract

A 52-year-old man received partial left nephrectomy for renal cell carcinoma (clear cell carcinoma, G1, pT1aN0M0) in January, 2003. After 7 years, he was diagnosed with mediastinal lymph node metastasis and we performed interferon-alpha therapy. After 7 months, he presented with dyspnea. Chest X rays showed a large globular cardiac shadow. Echocardiography revealed massive pericardial effusion with features of cardiac tamponade. Under echocardiographic guidance, 1, 020 ml hemorrhagic pericardial fluid was aspirated ; the fluid revealed class V and our diagnosis was pericardial metastasis of renal cell carcinoma. We performed treatment with sunitinib for 5 months after pericardiocectesis. Metastatic mediastinal lymph node size was maintained showing stable disease by computed tomography and cardiac effusion was not increased, but he died unexpectedly at home.