ArticleJACC. Case reports2026
Constrictive Pericarditis Due to Metastatic Squamous Cell Carcinoma: A Rare and Ominous Condition.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundConstrictive pericarditis is an uncommon but serious condition typically caused by idiopathic inflammation, prior cardiac surgery, or radiation. Malignancy is a rare etiology. CASE SUMMARY: A 62-year-old man with a history of tongue squamous cell carcinoma on long-term pembrolizumab presented with dyspnea, orthopnea, leg swelling, and ascites. Multimodal imaging revealed nodular pericardial thickening and constrictive physiology. Given lack of improvement on anti-inflammatory therapy and need to differentiate between metastatic disease versus immunotherapy-related inflammation, surgical pericardiectomy with biopsy was pursued. Histopathology confirmed poorly differentiated metastatic carcinoma invading the myocardium. Owing to poor prognosis, care was transitioned to hospice. DISCUSSION: Malignant pericardial involvement with constriction is a rare but important diagnostic consideration, particularly when atypical features or poor response to therapy are present. Immune checkpoint inhibitor-associated pericarditis can mimic malignant involvement, complicating noninvasive diagnosis. TAKE-HOME MESSAGE: When advanced imaging cannot definitively distinguish between immune-mediated and malignant pericarditis, tissue diagnosis is necessary.
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