key: cord-0050452-7rdxw0m2
authors: Imazio, Massimo
title: Pericardiocentesis With Extended Drainage and Colchicine: New Indication for Malignant Pericardial Effusions?
date: 2020-09-29
journal: J Am Coll Cardiol
DOI: 10.1016/j.jacc.2020.08.008
sha: 96086b7aad65ed3485d4a5042a7c44a58bb6fb83
doc_id: 50452
cord_uid: 7rdxw0m2

[Figure: see text]

P ericardial effusion is a relatively common manifestation in malignancies, often associated with a poor prognosis (1) (2) (3) . However, a direct cancer involvement of the pericardium has been reported in up to 45% of cases, and up to twothirds of pericardial effusions are not due to direct cancer invasion (4) (5) (6) (7) (8) . Secondary or metastatic pericardial invasion is relatively common in solid tumors (lung and breast cancer) and hematological malignancies, whereas primary neoplasms of the pericardium are rare. Pericardial disease may principally develop from direct or metastatic spread of the primary malignancy, or as a complication of systemic tumor treatment (radiotherapy and chemotherapy); the differential diagnosis of the underlying mechanism has an important therapeutic and prognostic impact in terms of either recurrence or survival. The spectrum of malignant pericardial disease may range from asymptomatic pericardial effusion to hemodynamic instability in the setting of cardiac tamponade and constrictive pericarditis. Colchicine is an old anti-inflammatory drug with a known and well-established role for the treatment and prevention of pericarditis (13, 14) , and could Twitter: @ImazioMassimo.

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