Case Report
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastrointest Oncol. Apr 15, 2011; 3(4): 67-70
Published online Apr 15, 2011. doi: 10.4251/wjgo.v3.i4.67
Primary gastric signet ring cell carcinoma presenting as cardiac tamponade
Jun-Yan Huang, Hai-Ping Jiang, Dan Chen, Han-Lin Tang
Jun-Yan Huang, Hai-Ping Jiang, Han-Lin Tang, Department of General Surgery, The First Affiliated Hospital of Jinan University, West No. 613, Huangpu Road, Guangzhou 510630, Guangdong Province, China
Dan Chen, Department of General Surgery, The First Affiliated Hospital of Guang Dong Pharmaceutical University, No. 19 Nonglinxia Road, Yuexiu District, Guangzhou 510080, Guangdong Province, China
Author contributions: Huang JY and Jiang HP designed the study; Huang JY, Chen D and Tang HL acquired, analyzed and interpreted the data; Huang JY and Jiang HP revised and finally approved the final version.
Correspondence to: Jun-Yan Huang, MCh, Department of General Surgery, The First Affiliated Hospital of Jinan University, West No. 613, Huangpu Road, Guangzhou 510632, Guangdong Province, China. margaret_wong@msn.com
Telephone: +86-20-38688024  Fax: +86-20-38688888
Received: December 31, 2010
Revised: March 3, 2011
Accepted: March 10, 2011
Published online: April 15, 2011
Abstract

Primary gastric signet ring cell carcinoma presenting as cardiac tamponade is difficult to diagnosis early. Patients are generally asymptomatic until the disease is advanced. General practitioners usually focus on the initial symptoms related to pericarditis and pericardial effusion. We report a case of signet-ring cell carcinoma of the stomach presenting as cardiac tamponade with pericarditis and pericardial effusion but without any gastrointestinal symptoms. A 49-year old woman was admitted because of progressive dyspnea and cough. Chest X-ray revealed an increased cardiothoracic ratio and a small amount of bilateral pleural effusion. Two dimensional ultrasonographic echocardiography pericardial effusions with atrial and right ventricular early diastolic collapse were found, establishing the diagnosis of cardiac tamponade. Pericardiocentesis was performed and 420 mL of bloody fluid was taken. The patient died of respiratory failure and cardiac arrest on October 28, 2009. Post-mortem examination revealed diffuse gastric mucosa erosion and edema with stomach mucosa incrassation in the greater curvature. The primary lesion was histopathologically diagnosed as signet-ring cell carcinoma of the stomach.

Keywords: Cardiac tamponade; Gastric signet-ring cell carcinoma; Pericarditis; Pericardial effusion