To cite: Vijayalakshmi IB, Agrawal N, Mallikarjun K, et al. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2013200275 DESCRIPTION We present an interesting image of a ‘floating left atrial (LA) appendage’ in a 5-month-old female infant with pericardial tamponade. Clinical features of respiratory distress, lethargy and difficulty in suckling were present and the j...

This report describes a patient with chylous pleural and pericardial effusions in conjunction with severe lymphoedema resembling elephantiasis. The chylous effusions and generalized lymphoedema were associated with a signet-ring cell carcinoma.