Successful Treatment of Pericardial Drainage and Platinum-Based Chemotherapy in a Case of BRCA-Positive Serous Peritoneal Carcinoma Complicated by Cardiac Tamponade

TL;DR

A 72-year-old patient with a rare form of cancer and heart complications was successfully treated with pericardial drainage and chemotherapy.

Contribution

This is the first reported case of effective platinum-based chemotherapy for BRCA-positive peritoneal cancer with cardiac tamponade.

Findings

Pericardial drainage and platinum-based chemotherapy led to rapid improvement in cancer antigen 125 levels.

CT scans showed disappearance of peritoneal dissemination and ascites after four chemotherapy cycles.

The patient completed six chemotherapy courses and was scheduled for maintenance therapy with PARP inhibitors.

Abstract

Cases of serous peritoneal carcinoma complicated by cardiac tamponade due to cancerous pericardial effusion are extremely rare and have poor prognoses. We report a case of a 72-year-old patient who presented with epigastric discomfort and was diagnosed with serous peritoneal carcinoma complicated by cardiac tamponade. The patient underwent emergency pericardial drainage for the cardiac tamponade. Subsequently, she was diagnosed with BRCA1-positive peritoneal carcinoma and was administered carboplatin, paclitaxel, and bevacizumab. After treatment initiation, cancer antigen 125 levels decreased rapidly, and no recurrence of pericardial effusion was observed. CT after four cycles of chemotherapy showed the disappearance of peritoneal dissemination and ascites. The patient completed six courses of induction chemotherapy and was scheduled to undergo maintenance therapy with PARP inhibitors. We report the first case of effective platinum-based chemotherapy in a patient with BRCA-positive peritoneal cancer complicated by cardiac tamponade. Chemotherapy has advanced dramatically in recent years, and even in cases with complications, such as cardiac tamponade, appropriate treatment can lead to a favorable long-term prognosis.

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