Case Report: A Crushing Sensation-a Rare Case of Mediastinal Germ Cell Tumor Causing Cardiac Tamponade

Overview

Journal Front Cardiovasc Med

Date 2025 Feb 4

PMID 39902085

Authors

Kevin S Tang

Emin Zargarian

Pranav M Patel

Affiliations

Soon will be listed here.

Abstract

Cardiac tamponade often presents as external compression of the heart by pericardial fluid, leading to hemodynamic instability, but it can rarely be caused by compression by a solid mass. In this report, we present a case of tamponade-like physiology resulting from a large mediastinal tumor. This is an unusual phenomenon that is rarely described in the literature, and its optimal management remains controversial. This report reviews the clinical considerations for this rare pathophysiology; definitive therapy requires the involvement of a multidisciplinary approach for hemodynamic optimization and mass removal.

References

Narang S, Harte B, Body S . Anesthesia for patients with a mediastinal mass. Anesthesiol Clin North Am. 2001; 19(3):559-79. DOI: 10.1016/s0889-8537(05)70247-9. View

Schusler R, Meyerson S . Pericardial Disease Associated with Malignancy. Curr Cardiol Rep. 2018; 20(10):92. DOI: 10.1007/s11886-018-1040-5. View

Kesler K, Stram A, Timsina L, Turrentine M, Brown J, Einhorn L . Outcomes following surgery for primary mediastinal nonseminomatous germ cell tumors in the cisplatin era. J Thorac Cardiovasc Surg. 2020; 161(6):1947-1959.e1. DOI: 10.1016/j.jtcvs.2020.01.118. View

Rath L, Gullahorn G, Connolly N, Pratt T, Boswell G, Cornelissen C . Anterior mediastinal mass biopsy and resection: anesthetic techniques and perioperative concerns. Semin Cardiothorac Vasc Anesth. 2012; 16(4):235-42. DOI: 10.1177/1089253212454336. View

Erdos G, Tzanova I . Perioperative anaesthetic management of mediastinal mass in adults. Eur J Anaesthesiol. 2009; 26(8):627-32. DOI: 10.1097/EJA.0b013e328324b7f8. View

Overvad T, Ording A, Nielsen P, Skjoth F, Albertsen I, Noble S . Validation of the Khorana score for predicting venous thromboembolism in 40 218 patients with cancer initiating chemotherapy. Blood Adv. 2022; 6(10):2967-2976. PMC: 9131922. DOI: 10.1182/bloodadvances.2021006484. View

Bosch F, Mulder F, Kamphuisen P, Middeldorp S, Bossuyt P, Buller H . Primary thromboprophylaxis in ambulatory cancer patients with a high Khorana score: a systematic review and meta-analysis. Blood Adv. 2020; 4(20):5215-5225. PMC: 7594395. DOI: 10.1182/bloodadvances.2020003115. View

Laurent F, Latrabe V, Lecesne R, Zennaro H, Airaud J, Rauturier J . Mediastinal masses: diagnostic approach. Eur Radiol. 1998; 8(7):1148-59. DOI: 10.1007/s003300050525. View

Chetrit M, Lipes J, Mardigyan V . A Practical Approach to Pericardiocentesis With Periprocedural Use of Ultrasound Training Initiative. Can J Cardiol. 2018; 34(9):1229-1232. DOI: 10.1016/j.cjca.2018.06.004. View

10.

Honasoge A, Dubbs S . Rapid Fire: Pericardial Effusion and Tamponade. Emerg Med Clin North Am. 2018; 36(3):557-565. DOI: 10.1016/j.emc.2018.04.004. View

11.

Lim W, Kaisbain N, Abu Bakar R, Hadi H, Mohamed Yusof A . Secondary cardiac lymphoma presenting with cardiac tamponade and cardiac mass: a case report. Cardiooncology. 2024; 10(1):31. PMC: 11102117. DOI: 10.1186/s40959-024-00202-8. View

12.

Ghazi F, Underwood D . Extracardiac mass causing cardiac tamponade in a patient with disseminated lymphoma. Cleve Clin J Med. 1987; 54(4):311-3. DOI: 10.3949/ccjm.54.4.311. View

13.

Vanneman M, Fikry K, Quraishi S, Schoenfeld W . A Young Man with a Mediastinal Mass and Sudden Cardiac Arrest. Ann Am Thorac Soc. 2015; 12(8):1235-9. PMC: 4566412. DOI: 10.1513/AnnalsATS.201504-212CC. View

14.

Adi O, Fong C, Ahmad A, Panebianco N . Worsening cardiac tamponade after pericardiocentesis in a patient with anterior mediastinum mass: a case report. Eur Heart J Case Rep. 2022; 6(8):ytac329. PMC: 9395134. DOI: 10.1093/ehjcr/ytac329. View

15.

Vu K, Luong N, Hubbard J, Zalpour A, Faderl S, Thomas D . A retrospective study of venous thromboembolism in acute leukemia patients treated at the University of Texas MD Anderson Cancer Center. Cancer Med. 2014; 4(1):27-35. PMC: 4312115. DOI: 10.1002/cam4.332. View

16.

Juanpere S, Canete N, Ortuno P, Martinez S, Sanchez G, Bernado L . A diagnostic approach to the mediastinal masses. Insights Imaging. 2012; 4(1):29-52. PMC: 3579993. DOI: 10.1007/s13244-012-0201-0. View