CARDIAC-TAMPONADE AS THE INITIAL PRESENTATION OF PAPILLARY THYROID-CARCINOMA

Hypothyroidism is a well known cause of pericardial effusions and card iac tamponade; thyroid carcinoma metastatic to the heart and pericardi um is rarely encountered in clinical practice. The authors report the case of a 68-year-old male who presented in acute distress from cardia c tamponade. Cytological examination of the pericardial and pleural fl uid, and histological examination of a pericardial biopsy revealed a m etastatic papillary carcinoma with psammoma bodies. Subsequent reexami nation of the patient demonstrated a thyroid nodule and bilateral cerv ical lymphadenopathy. Fine needle aspiration of the thyroid nodule and cervical lymph nodes detected a papillary thyroid carcinoma with meta stases to the lymph nodes. The literature relevant to hypothyroidism, thyroid malignancy and cardiac tamponade is briefly reviewed.