A case of recurrent breast cancer complicated with pericardial effusions and cardiac tamponade

A 56-year-old female with breast cancer after left partial mastectomy and subaxillary lymph node dissection was treated with adjuvant chemoradiotherapy. After one year left lung metastasis and malignant pleural effusion had resisted and progressed against several types of chemotherapy. Although combination chemotherapy of trastuzumab and vinorelbine was started, pericardial effusions progressed. Emergent pericardiocentesis was performed, and the catheter was left in the pericardial space. The adenocarcinoma was detected from effusion. On days 3, 5 and 7, after further pericardial drainage, the intracavitary treatment with a 15 mg bolus of thiotepa and 30 mg hydrocortisone was administered, and the catheter was removed the following day. The recurrence of pericardial effusions was not seen in four months until death. Pericardiocentesis and intrapericardial instillation of thiotepa were effective in our case with pericardial effusions.