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Background <p>Malignant pericardial effusion (PE) and subsequent effusive-constrictive pericarditis (ECP) are significant clinical challenges in patients with advanced cancer.</p> Case presentation <p>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&#xa0;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&#xa0;months across all three patients. Pericardial stabilization was maintained despite subsequent progression of the underlying malignancy.</p> Conclusion <p>In this case series, high-dose (200&#xa0;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.</p>

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

  • 期刊论文

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  • 发表日期：

    2026年3月28日

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  • Nuri Lee,
  • Yoojin Kim,
  • Hyukjin Park

摘要

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.