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Case Reports

Open Access Special Issue

Cardiac tamponade as an unusual initial presentation of squamous cell carcinoma of the esophagus

  • Nitchakarn Hongsuphan1
  • Saowaluck Faikongngeon1
  • Wachira Wongtanasarasin1,*,

1Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, 50200 Chiang Mai, Thailand

DOI: 10.22514/sv.2021.120 Vol.18,Issue 6,November 2022 pp.110-113

Submitted: 10 May 2021 Accepted: 01 June 2021

Published: 08 November 2022

(This article belongs to the Special Issue Efficacy of Medication Administered During Adult Cardiac Arrest)

*Corresponding Author(s): Wachira Wongtanasarasin E-mail:


Pericardial effusions leading to cardiac tamponade have previously been described with esophageal cancer. However, up to eighty percent of these cases have been reported in association with chemotherapy and radiation. Patients with esophageal cancer seldom initially present with pericardial effusion resulting from esophageal pericardial fistula (EPF). Herein, we present the case of a 62-year-old man who presented with pericardial effusion with an unknown etiology at presentation. Subsequently, the patient developed cardiac tamponade and was referred to the tertiary hospital for further evaluation. Computed tomography of the chest revealed a circumferential irregular enhancing lesion at the mid-thoracic esophagus suspecting esophageal cancer with EPF and a moderate amount of pericardial effusion. The patient underwent esophagoscopy and squamous cell carcinoma was found from the esophageal biopsy. An esophageal stent was successfully placed to conceal the perforation. Eventually, the patient died 13 days after admission complicated by refractory septic shock. This case highlights an atypical presentation of esophageal cancer and an unusual cause of cardiac tamponade.


Cardiac tamponade; Esophageal cancer; Pericardial effusion; Esophagus; Esophageal pericardial fistula

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Nitchakarn Hongsuphan,Saowaluck Faikongngeon,Wachira Wongtanasarasin. Cardiac tamponade as an unusual initial presentation of squamous cell carcinoma of the esophagus. Signa Vitae. 2022. 18(6);110-113.


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