J Korean Soc Radiol.  2019 Jul;80(4):815-819. 10.3348/jksr.2019.80.4.815.

A Gastro-Pleuro-Pericardial Fistula That Occurred Following Palliative Chemoradiotherapy for Tongue Cancer: A Case Report

• Jang SJ
• Cha YK
• Kim JS
• Kim DY
• Kim DB

• KMID: 2457464
• DOI: http://doi.org/10.3348/jksr.2019.80.4.815

Abstract

A gastro-pleuro-pericardial fistula is an abnormal communication between the stomach, pleural cavity, and pericardium. It is a very rare and life-threatening condition, which needs prompt intervention. We report a case of gastro-pleuro-pericardial fistula in a patient with tongue cancer who was treated with chemoradiotherapy. A 41-year-old woman presented with left chest discomfort and dyspnea. She was diagnosed with left pleural metastasis from tongue cancer and was treated with chemoradiotherapy on the left posteroinferior chest wall. A CT revealed the abnormal connection between the gastric fundus, left pleura and pericardium, showing gastro-pleuro-pericardial fistula.

MeSH Terms

Adult
Chemoradiotherapy*
Drug Therapy
Dyspnea
Female
Fistula*
Gastric Fundus
Humans
Neoplasm Metastasis
Pericardium
Pleura
Pleural Cavity
Radiotherapy
Stomach
Thoracic Wall
Thorax
Tomography, X-Ray Computed
Tongue Neoplasms*
Tongue*

Figure

• 

  Fig. 1 A gastro-pleuro-pericardial fistula in a 41-year-old woman with tongue cancer who was treated with chemoradiotherapy. A. Chest radiograph shows a large amount of pneumopericardium, bilateral pleural effusion, and a large cavity (asterisk) with air-fluid level at the left lower portion, distinct from stomach air (arrow). B, C. Follow-up chest CT scans in the coronal (lung window image, B) and axial (mediastinal window image, C) views show a large amount of pneumopericardium and abnormal connection (arrows) between the pleura and pericardium. The cavity with the air-fluid level demonstrated on radiography is identified as hydropneumothorax on CT (asterisk, C) D. Another sagittal view shows the passage between the stomach and pleura (white arrow), as well as between the pleura and pericardium (black arrow), thereby depicting the gastro-pleuro-pericardial fistula.

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