INTRODUCTION: Erdheim-Chester disease is a rare, non-Langerhans histiocytosis in which pericardial involvement is diagnosed with increasing frequency and is associated with high mortality rates. PRESENTATION OF CASE: A 53-year-old woman presented with progressive exertional dyspnea and pericardial effusion was discovered. Further investigations revealed the presence of a diffuse, infiltrating process and a diagnosis of Erdheim-Chester disease was made. An emergent pericardiocentesis by subxiphoid approach was completed but recurrent drainage obviated removal of the pigtail catheter. A pleuro-pericardial window was placed using video-assisted thoracoscopic surgery (VATS) and analysis of the resected specimen confirmed pericardial involvement. DISCUSSION: In this case, high pericardial fluid output demanded definitive treatment of the pericardial effusion. Traditionally this would be completed via thoracotomy. VATS is a minimally invasive alternative which permits exploration of the thoracic cavity and the creation of a pleuropericardial window. CONCLUSION: We describe, for the first time, the successful use of VATS for both diagnostic confirmation and therapeutic relief of recurrent pericardial fluid drainage due to pericardial involvement by Erdheim-Chester disease.
INTRODUCTION:Erdheim-Chester disease is a rare, non-Langerhans histiocytosis in which pericardial involvement is diagnosed with increasing frequency and is associated with high mortality rates. PRESENTATION OF CASE: A 53-year-old woman presented with progressive exertional dyspnea and pericardial effusion was discovered. Further investigations revealed the presence of a diffuse, infiltrating process and a diagnosis of Erdheim-Chester disease was made. An emergent pericardiocentesis by subxiphoid approach was completed but recurrent drainage obviated removal of the pigtail catheter. A pleuro-pericardial window was placed using video-assisted thoracoscopic surgery (VATS) and analysis of the resected specimen confirmed pericardial involvement. DISCUSSION: In this case, high pericardial fluid output demanded definitive treatment of the pericardial effusion. Traditionally this would be completed via thoracotomy. VATS is a minimally invasive alternative which permits exploration of the thoracic cavity and the creation of a pleuropericardial window. CONCLUSION: We describe, for the first time, the successful use of VATS for both diagnostic confirmation and therapeutic relief of recurrent pericardial fluid drainage due to pericardial involvement by Erdheim-Chester disease.
Authors: C Myra; L Sloper; P J Tighe; R S McIntosh; S E Stevens; R H S Gregson; M Sokal; A P Haynes; R J Powell Journal: Br J Ophthalmol Date: 2004-06 Impact factor: 4.638
Authors: D W Moores; K B Allen; L P Faber; S W Dziuban; D J Gillman; W H Warren; R Ilves; L Lininger Journal: J Thorac Cardiovasc Surg Date: 1995-03 Impact factor: 5.209
Authors: Dawn E Jaroszewski; Gregory T Altemose; Luis R Scott; Komandoor Srivasthan; Patrick A Devaleria; Jesse Lackey; Francisco A Arabia Journal: Ann Thorac Surg Date: 2009-07 Impact factor: 4.330
Authors: Emad E Abdellateef; Ayman R Abdelhai; Heba H Gawish; Ghada A Abdulmonaem; Eman H Abdelbary; Ahmed I Ahmed Journal: Am J Case Rep Date: 2016-05-30