How is neoplastic pericarditis diagnosed?

Updated: Apr 02, 2019
  • Author: Sean Spangler, MD; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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Answer

In neoplastic pericarditis, the pericardial carcinoembryonic antigen (CEA) level is often elevated. Cytology findings are positive in 80-90% of breast and lung cancer cases, but the percentage is lower in other malignancies. Obstruction of the lymphatic drainage can cause the pericardial effusion to be more significant than the tumor mass.

The ESC 2004 guideline recommends pericardial drainage in all neoplastic pericarditis patients with large effusions because of the high recurrence rate (40-70%). Tetracyclines used as sclerosing agents control malignant pericardial effusion in roughly 85% of cases, but side effects and complications such as fever, chest pain, and atrial arrhythmias, are frequent. [32]


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