A plasma cell-based pericardial effusion leading to tamponade in a patient with multiple myeloma - a case report and review of the literature

Cardiovasc Pathol. 2019 May-Jun:40:41-46. doi: 10.1016/j.carpath.2019.02.002. Epub 2019 Feb 10.

Abstract

A rare case of extramedullary multiple myeloma causing cardiac tamponade secondary to a plasma cell-based pericardial effusion is described. A systematic search using PubMed (National Library of Medicine) was used to identify a further 27 cases dating back to 1970. Case characteristics, treatment strategies, and survival time following tamponade are discussed. Linear regression demonstrated a weak but statistically significant correlation between survival time following tamponade and treatment with systemic chemotherapy and steroids (β=16.8 weeks, P=.009). However, this manifestation of extramedullary multiple myeloma still conveys a dismal prognosis with a median survival following tamponade of only 6 weeks based on our review.

Keywords: Cardiac tamponade; Multiple myeloma; Pericardial effusion; Plasma cell; Plasmacytoma.

Publication types

  • Case Reports
  • Systematic Review

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biopsy
  • Cardiac Tamponade / diagnostic imaging
  • Cardiac Tamponade / etiology*
  • Cardiac Tamponade / surgery
  • Echocardiography
  • Fatal Outcome
  • Female
  • Humans
  • Multiple Myeloma / complications*
  • Multiple Myeloma / drug therapy
  • Multiple Myeloma / pathology
  • Pericardial Effusion / diagnostic imaging
  • Pericardial Effusion / etiology*
  • Pericardial Effusion / surgery
  • Pericardiocentesis
  • Plasma Cells / drug effects
  • Plasma Cells / pathology*
  • Risk Factors
  • Treatment Outcome