Publication:

Unmasking lung adenocarcinoma through the pericardium: a case of malignant effusion with early tamponade

Pericardial effusion as an initial presentation of primary lung carcinoma is uncommon and poses diagnostic challenges due to its nonspecific clinical manifestation. Herein we report a case of a 51-year-old female with known diabetes mellitus, hypertension, and hypothyroidism who presented with generalized anasarca and dyspnea. Imaging revealed a right upper lobe mass with bilateral pulmonary metastases and moderate-to-severe pericardial effusion with early tamponade features. Cytological analysis of the pericardial fluid demonstrated malignant cells suggestive of adenocarcinoma, which was confirmed on histopathological examination of a lung biopsy. This case highlights the importance of considering malignancy, particularly adenocarcinoma of the lung, in patients presenting with pericardial effusion, even in the absence of prior cancer diagnosis.