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. 2022 May 6:12:871132.
doi: 10.3389/fonc.2022.871132. eCollection 2022.

Would the Addition of Immunotherapy Impact the Prognosis of Patients With Malignant Pericardial Effusion?

Varsha Chiruvella  1 , Asad Ullah  1 , Islam Elhelf  1 , Nikhil Patel  1 , Nagla Abdel Karim  1
Affiliations

Would the Addition of Immunotherapy Impact the Prognosis of Patients With Malignant Pericardial Effusion?

Varsha Chiruvella et al. Front Oncol. .

Abstract

Pericardial effusion is a common finding in advanced-stage lung cancer. The presence of malignant cells or drainage of exudate effusion in the pericardial space may cause symptoms of dyspnea, pleuritic chest pain, and syncope. In addition to the difficulty physicians face in the detection and diagnosis of malignant pericardial effusion, treatment may be challenging considering the cancer prognosis and cardiovascular stability of the patient. Despite the availability of several treatment modalities for malignant pericardial effusion, including chemotherapy and surgery, patients with lung cancer historically present with poor prognoses. In addition to lung adenocarcinoma with malignant pericardial effusion, this case was complicated by COVID-19 and malignancy-associated obstructive pneumonia. We present a case of a 64-year-old woman with advanced non-small cell lung carcinoma (NSCLC) with malignant pericardial effusion who, despite testing positive for COVID-19 and having obstructive pneumonia, had favorable outcomes following systemic therapy with combined chemo-immunotherapy.

Keywords: adenocarcinoma; combined chemoimmunotherapy; immunotherapy; malignant pericardial effusion; pneumonia.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
A CT scan of the chest without contrast. (A) Axial image showing a right upper lobe mass measuring approximately 5.5 × 4.0 cm in maximum axial dimensions. (B) Coronal image showing the right upper lobe mass contacting the pleura. (C) Axial image showing a large pericardial effusion (yellow arrows) and a small right pleural effusion (blue arrow).
Figure 2
Figure 2
(A) H&E ×40: Poorly forming glands with vacuolated cytoplasm, hyperchromatic and pleomorphic nuclei, and an identifiable mitosis (arrow). (B) TTF1 stain: a cluster of tumor cells shows nuclear positivity.
See this image and copyright information in PMC

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