Neoplastic pericardial effusion (NPE) presents a significant challenge in medical pathology. Timely management is crucial for survival and quality of life. However, data on NPE in our country are scarce.

This study aims to provide a comprehensive description of patients with NPE in our context.

A retrospective cohort study at Ibn Rochd Cardiology Department and Oncology Unit in Casablanca over three years (January 2020 to December 2022) included NPE-diagnosed patients based on clinical, biological, histological, and echocardiographic criteria. Data encompassed sociodemographic details, clinical manifestations, echocardiography findings, cytology of pericardial fluid, and therapeutic protocols.

Forty-nine patients were included, the median age was 42 years, with a sex ratio of 1.17. Sixty-five percent exhibited compromised functional status (PS≥2). Symptomatic presentation was common, with dyspnea reported in 57.5% and cardiac tamponade in 20% of cases. Lung tumors (43%) and breast tumors (39%) were the predominant etiologies. Pericardial involvement preceding other metastatic sites in 61.2% of cases. Positive cytology was found in 47% of cases, with non-small cell lung cancer (NSCLC) being the most common histological type (31%). Transthoracic echocardiography revealed significant pericardial effusion in 79.5% of cases, along with other abnormalities. Pericardiocentesis was performed in all patients, with systemic treatments including chemotherapy, targeted therapy, or radiation. The overall mortality rate was 60%, with lung cancer-associated neoplastic pericardial effusion having the highest mortality rate at 88%.

This study elucidates the management approach towards neoplastic pericardial effusion within our patient cohort. The high mortality rate, especially in lung cancers, emphasizes the need for early detection and targeted treatments to improve outcomes.