A rare case of pancreatic adenocarcinoma accompanied by venous thrombosis, pleural and pericardial effusions

Abstract

Introduction: Pancreatic cancer is a deadly type of cancer with few symptoms until metastasis. It poses a high risk of cancer-associated thrombosis.

Case presentation: A 73-year-old male presented with fatigue, shortness of breath, weight loss since 9 months, and blood clots recently in his legs. Chest radiography revealed fluid accumulation in pleural and pericardial cavities. Later, a fluid examination revealed the presence of malignant cells in the pericardial fluid. After immunological tests and an upper gastrointestinal endoscopy were performed, a pancreatic tumour was suspected. The patient was administered anticoagulant treatment and palliative care, which resulted in improvement after one month.

Discussion: Pancreatic adenocarcinoma is a highly aggressive cancer with a strong tendency to metastasize, leading to pericardial and pleural effusion, thrombophlebitis, and poor prognosis.

Conclusion: This case indicates that venous thrombosis, pleural and pericardial effusions could be symptoms related to a pancreatic tumour.

Keywords: case report; pancreatic adenocarcinoma; pericardial effusions; pleural effusions; venous thrombosis.

Figure 1

Chest X-ray. (A) Pleural effusion in both lungs, with a more pronounced loss of the costo-phrenic angle in the right lung (blue arrow). Additionally, there is pericardial effusion, indicated by a spherical enlargement of the cardiac shadow, resembling a water bottle (red arrow). (B) The day after pleural aspiration. (C) One week after pleural and pericardial fluid aspiration.

Figure 2

CT (A) shows a cross section, while (B) shows a coronal section. Both sections detect a pleural effusion (indicated by the blue arrow) and a pericardial effusion (indicated by the red arrow).