A CASE OF CARDIAC TAMPONADE INDUCED BY CARDIAC METASTASIS OF A GASTRIC CANCER TWO YEARS AFTER A SURGICAL TREATMENT

There is an increasing tendency to detect cardiac metastasis of malighant neoplasms in autopsy. However, at times, it is difficult to diagnose cardiac metastasis clinically. We experienced a case of cardiac tamponade induced by cardiac metastasis of a gastric cancer 2 years after a curative surgical treatment. A 51-year-old male underwent total gastrectomy (Curability A) for a Borrmann 3 type gastric cancer (CM, Less) (sig) in May, 1992. Carbohydrate antigen 19-9 (CA19-9) started to increase over the normal range in April, 1994. but no recurrence was found by upper GI endoscopy and adbominal CT. In August 23, 1994, he was admitted to the hospital because of an epigastralgia and dyspnea caused by cardiac tamponade. The pericardial effusion taken by drainage was bloody showed, class V in cytology and was associated with high value of CA19-9. He died of pulmonary edema caused by space occupying mass in the left strium 3 months after the drainage. An autopsy disclosed cardiac metastasis of the gastric cancer through lymphatic route of the diaphragma.