Malignant pericardial effusion with cardiac tamponade in ovarian adenocarcinoma

Malignant pericardial effusion with cardiac tamponade is an uncommon metastatic manifestation of gynecologic cancers. We describe a patient with ovarian cancer who developed pericardial effusion with cardiac tamponade and was successfully treated with pericardiocentesis and intrapericardial instillation of thiotepa. A 52-year-old woman with stage IV ovarian adenocarcinoma presented with worsening cough, dyspnea, and fatigue. Chest X-ray and echocardiogram confirmed the presence of pericardial effusion with cardiac tamponade. Pericardial fluid cytology revealed adenocarcinoma. Treatment consisted of pericardiocentesis with thiotepa sclerotherapy. She survived 12 months post-therapy without recurrent pericardial tamponade. Patients with gynecologic cancers may develop a pericardial effusion with cardiac tamponade. Malignant pericardial effusion should be included in the differential diagnosis in patients with recurrent ovarian cancer who present with cardiac tamponade.