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Intrapericardial corticosteroid therapy for recurrent malignant pericardial effusion: a case series

Year: 2026

Type: article

Abstract: BACKGROUND: Malignant pericardial effusion (PE) and subsequent effusive-constrictive pericarditis (ECP) are significant clinical challenges in patients with advanced cancer. CASE PRESENTATION: We report three patients with metastatic breast or lung cancer who experienced recurrent, life-threatening cardiac tamponade despite multiple pericardiocenteses (PCC) and systemic anti-inflammatory treatment (AIT). In all cases, pericardial disease recurred despite conventional management, while chronic systemic corticosteroid use led to debilitating adverse effects. Following complete drainage of the PE, a single high-dose bolus of 200 mg triamcinolone was administered via an intrapericardial catheter with a 12-h clamping protocol. This intervention was associated with sustained pericardial stabilization for 8 to 47 months across all three patients. Pericardial stabilization was maintained despite subsequent progression of the underlying malignancy. CONCLUSION: In this case series, high-dose (200 mg) intrapericardial corticosteroid therapy may represent a feasible therapeutic option for selected patients with recurrent malignant PE after prior PCC when systemic AIT is ineffective or poorly tolerated.

Source: Cardio-Oncology

DOI: 10.1186/s40959-026-00479-x

Authors: Nuri Lee, Yoojin Kim, Hyukjin Park

Institutions: Chonnam National University Hwasun Hospital, Chonnam National University

Language: English

Topic: Pericarditis and Cardiac Tamponade

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,790