内容紹介
A Case of Carcinomatous Cardiac Tamponade Caused by Breast Cancer Treated with Instillation of Paclitaxel and Minocycline
Summary
The patient was a 56-year-old woman who had undergone the Patey operation for left breast cancer when she was 45 years old. She had complained of dyspnea and shortness of breath at the time of exercise. Bilateral accumulation of pleural effusion and pericardial fluid was observed on chest radiographs and computed tomography(CT)scans. Under the diagnosis of cardiac tamponade, the patient was treated with pericardial drainage and local chemotherapy(intra-pericardial dosage of paclitaxel 45 mg and minocycline 100 mg)with the aim of preventing the accumulation of pericardial effusion. Subsequently, the pericardial effusion continued to disappear. The patient was treated with systemic chemotherapy. At the age of 58 years, she died of breast cancer. After treatment with pericardial drainage and local chemotherapy, she did not experience pericardial reaccumulation or cardiac tamponade. Thus, the method of local chemotherapy(intra-pericardial dosage of paclitaxel 45 mg and minocycline 100 mg)was considered effective.
要旨
症例は56歳,女性。45歳時に乳癌に対して乳房腫瘤切除術および乳房切断術を施行した。56歳時に咳嗽,呼吸困難を自覚し,胸部X線など精査にて心嚢水,胸水の貯留を認めた。その後,心嚢水が増加し心タンポナーデを発症したため,緊急にエコーガイド下心嚢ドレナージ術を施行した。心嚢水細胞診がClass Ⅴであったため,再発乳癌による癌性心膜炎(心嚢炎)と診断した。再貯留を予防する目的にて,心嚢内にpaclitaxel 45 mg,minocycline 100 mgを投与した。その後は心嚢水の再貯留は認めず,心タンポナーデの発症もその後は認めなかった。心嚢内へのpaclitaxelおよびminocyclineの投与が乳癌の癌性心膜炎,心タンポナーデのコントロールに有効である可能性が示唆された。
目次
Summary
The patient was a 56-year-old woman who had undergone the Patey operation for left breast cancer when she was 45 years old. She had complained of dyspnea and shortness of breath at the time of exercise. Bilateral accumulation of pleural effusion and pericardial fluid was observed on chest radiographs and computed tomography(CT)scans. Under the diagnosis of cardiac tamponade, the patient was treated with pericardial drainage and local chemotherapy(intra-pericardial dosage of paclitaxel 45 mg and minocycline 100 mg)with the aim of preventing the accumulation of pericardial effusion. Subsequently, the pericardial effusion continued to disappear. The patient was treated with systemic chemotherapy. At the age of 58 years, she died of breast cancer. After treatment with pericardial drainage and local chemotherapy, she did not experience pericardial reaccumulation or cardiac tamponade. Thus, the method of local chemotherapy(intra-pericardial dosage of paclitaxel 45 mg and minocycline 100 mg)was considered effective.
要旨
症例は56歳,女性。45歳時に乳癌に対して乳房腫瘤切除術および乳房切断術を施行した。56歳時に咳嗽,呼吸困難を自覚し,胸部X線など精査にて心嚢水,胸水の貯留を認めた。その後,心嚢水が増加し心タンポナーデを発症したため,緊急にエコーガイド下心嚢ドレナージ術を施行した。心嚢水細胞診がClass Ⅴであったため,再発乳癌による癌性心膜炎(心嚢炎)と診断した。再貯留を予防する目的にて,心嚢内にpaclitaxel 45 mg,minocycline 100 mgを投与した。その後は心嚢水の再貯留は認めず,心タンポナーデの発症もその後は認めなかった。心嚢内へのpaclitaxelおよびminocyclineの投与が乳癌の癌性心膜炎,心タンポナーデのコントロールに有効である可能性が示唆された。