Case Presentation: A 61 year-old-female presented to an outside institution with worsening exertional dyspnea, chest pressure, and fatigue. Echocardiogram revealed a large pericardial effusion bordering on tamponade which was drained with great improvement of symptoms. CT Chest/Abdomen/Pelvis revealed perirenal soft tissue invasion, which was biopsied. Patient was then referred to our institution for further management; [...]