s-1-(combination) and Cardiac-Tamponade

A 56-year-old man was admitted to our hospital for gastric cancer. He had dyspnea before admission. Chest CT scan showed massive pericardial and pleural effusion. He was treated by cardiac drainage, and cytology of the effusion showed class V. We injected mitomycin C 10 mg into the pericardiac cavity, and also administered S-1 100 mg per day. His dyspnea improved and he was discharged. Afterward the dyspnea re-appeared, and he died 9 months after the diagnosis. We report this rare case of cardiac tamponade induced by gastric cancer responding to S-1 with a review of the literature.

Topics: Antimetabolites, Antineoplastic; Cardiac Tamponade; Drug Combinations; Humans; Male; Middle Aged; Oxonic Acid; Stomach Neoplasms; Tegafur

A 59-year-old man complaining of dyspnea, anterior chest oppression, and hypotension was diagnosed to have cardiac tamponade due to massive pericardial effusion. A cytological analysis of the pericardial effusion disclosed adenocarcinoma. An endoscopic study revealed gastric cancer in the lesser curvature wall of the middle body of the stomach, and signet-ring cell carcinoma was confirmed histologically. The gastric cancer was complicated by malignant pericardial effusion, and metastasis to the mediastinal lymph nodes. The patient was treated with pericardiocentesis followed by systemic chemotherapy consisting of TS-1 and cisplatin (CDDP). After 5 months, pericardial effusion disappeared and the primary gastric tumor decreased in size. Our experience suggests that the systemic chemotherapy of TS-1 and CDDP may be effective for controlling advanced gastric signet-cell carcinoma accompanied by malignant pericardial effusion.

Topics: Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Signet Ring Cell; Cardiac Tamponade; Cisplatin; Drug Combinations; Humans; Male; Middle Aged; Oxonic Acid; Stomach Neoplasms; Tegafur