Malignant Pericardial Effusion Secondary to Ovarian Adenocarcinoma Presenting with Cardiac Tamponade: A Case Report

Malignant pericardial effusion presenting with cardiac tamponade is a rare manifestation of metastatic gynecological cancer. Our patient, a 62-year-old female was presented with papillary serous adenocarcinoma of the right ovary in 2016. She was treated with interval cytoreduction surgery and platinum-based chemotherapy until 2018. Now, she presented with sudden onset dyspnea, tachypnea, tachycardia with hypotension, and distended jugular venous pressure. Echocardiography confirmed a large pericardial effusion with mild bilateral pleural effusion. She underwent an emergent pericardiocentesis which yielded 350 mL of hemorrhagic fluid and cytological examination of smears confirmed the presence of metastatic adenocarcinoma cells. The patient was managed conservatively and discharged after one week of hospitalization with a referral to the oncology center for further treatment. With increasing longevity and improved chemotherapeutic regimens, cases of malignant pericardial effusion with cardiac tamponade are on the rise, and therefore, clinicians need to be familiar with the prompt diagnosis and management of this life-threatening disease process.