<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>Introduction</h3>
<p>We report a rare case of an 80-year-old male patient with acute transformation of myelodysplastic syndrome (MDS) in the pericardial cavity, leading to cardiac tamponade.</p>
</sec>
<sec><h3>Case presentation</h3>
<p>The patient had been diagnosed with MDS 7 months prior. One day before presentation, he suddenly developed dyspnea. At presentation, his blood pressure was stable, but he was in tachycardic atrial fibrillation; echocardiography revealed a pericardial effusion. Aortic dissection and acute myocardial infarction were excluded by examination upon admission. His blood pressure subsequently dropped, indicating pericardial tamponade. Pericardiocentesis was performed, and 800 ml of bloody pericardial fluid were withdrawn, stabilizing his blood pressure. The blasts ratio was higher in the pericardial fluid than in the peripheral blood; bone marrow examination revealed no evidence of acute transformation, but the presence of numerous cells with chromosomal abnormalities in the pericardial sac cavity confirmed acute MDS transformation. The patient died on day 15 due to progressive multiorgan failure. The autopsy revealed a neoplastic lesion extending circumferentially throughout the epicardium.</p>
</sec>
<sec><h3>Conclusions</h3>
<p>When a patient with an acute onset history of hematogenous pericardial effusion is found to have a pericardial tamponade of cancerous origin, acute transformation of MDS should be considered in the differential diagnosis.</p>
</sec>
</abstract>

Introduction
We report a rare case of an 80-year-old male patient with acute transformation of myelodysplastic syndrome (MDS) in the pericardial cavity, leading to cardiac tamponade.

Case presentation
The patient had been diagnosed with MDS 7 months prior. One day before presentation, he suddenly developed dyspnea. At presentation, his blood pressure was stable, but he was in tachycardic atrial fibrillation; echocardiography revealed a pericardial effusion. Aortic dissection and acute myocardial infarction were excluded by examination upon admission. His blood pressure subsequently dropped, indicating pericardial tamponade. Pericardiocentesis was performed, and 800 ml of bloody pericardial fluid were withdrawn, stabilizing his blood pressure. The blasts ratio was higher in the pericardial fluid than in the peripheral blood; bone marrow examination revealed no evidence of acute transformation, but the presence of numerous cells with chromosomal abnormalities in the pericardial sac cavity confirmed acute MDS transformation. The patient died on day 15 due to progressive multiorgan failure. The autopsy revealed a neoplastic lesion extending circumferentially throughout the epicardium.

Conclusions
When a patient with an acute onset history of hematogenous pericardial effusion is found to have a pericardial tamponade of cancerous origin, acute transformation of MDS should be considered in the differential diagnosis.

An Autopsy Case of Acute Transformation of Myelodysplastic Syndrome Leading to Carcinomatous Cardiac Tamponade

Department of Emergency and Critical Care Medicine

Osaka Medical and Pharmaceutical University

Journal of Cardiovascular Emergencies

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Introduction
We report a rare case of an 80-year-old male patient with acute transformation of myelodysplastic syndrome (MDS) in the pericardial cavity,...

An Autopsy Case of Acute Transformation of Myelodysplastic Syndrome Leading to Carcinomatous Cardiac Tamponade

Article Category: Case Report

Published Online: Jun 27, 2024

Page range: 83 - 88

Received: May 30, 2024

Accepted: Jun 17, 2024

DOI: https://doi.org/10.2478/jce-2024-0013

Keywords
acute onset, hematogenous pericardial effusion, cardiac myeloid sarcoma

© 2024 Junji Hatakeyama et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

An Autopsy Case of Acute Transformation of Myelodysplastic Syndrome Leading to Carcinomatous Cardiac Tamponade

Article Category: Case Report

Published Online: Jun 27, 2024

Page range: 83 - 88

Received: May 30, 2024

Accepted: Jun 17, 2024

DOI: https://doi.org/10.2478/jce-2024-0013

Keywordsacute onset, hematogenous pericardial effusion, cardiac myeloid sarcoma

© 2024 Junji Hatakeyama et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
acute onset, hematogenous pericardial effusion, cardiac myeloid sarcoma