Vol. 6, Issue 2, Part A (2024)

Background: Ovarian cancer is the eighth most common cancer among women globally, with a high mortality rate. Malignant pericardial effusion (MPE) is a rare but severe complication of ovarian cancer, often indicative of advanced disease and poor prognosis.

Methods: We report a case of a 60-year-old female who presented with chest pain, difficulty breathing, and fatigue. Initial examinations revealed a severe pericardial effusion. Diagnostic tests included echocardiography, ECG, chest X-ray, and cytological analysis of pericardial fluid. Immunohistochemical (IHC) staining was used to determine the origin of the malignant cells.

Results: The echocardiography confirmed a severe pericardial effusion with cardiac tamponade effects. Pericardiocentesis drained 800ml of fluid, with cytology positive for metastatic adenocarcinoma. IHC staining was positive for PAX-8, confirming the gynecological origin of the cancer. Subsequent investigations diagnosed primary ovarian cancer at FIGO stage IVa, with elevated tumor markers. The patient was started on a chemotherapeutic regimen including paclitaxel, carboplatin, and bevacizumab.

Conclusion: This case underscores the importance of considering ovarian cancer as a potential underlying cause of MPE. Early diagnosis and aggressive management are critical in improving outcomes, though the prognosis remains poor. Multidisciplinary approaches are essential for optimal management of such complex cases.