Mixed Tumor of the Mediastinum of Mesenchymal Origin

Abstract

The occurrence of a tumor primary in the mediastinum and not originating from normal mediastinal structures is rare, particularly in children.The instance presented here is remarkable because pathologic study of the neoplasm revealed it to be malignant and composed of tissues derived from the mesoderm alone. REPORT OF CASEHistory.\p=m-\Aboy, 3 years and 3 months old, of Italian-American parentage, was admitted to the pediatric service of the Rhode Island Hospital on Jan. 17, 1935.The chief complaints were of a cold for one week and of fever and rapid breathing for four days.The family history was essentially unimportant. The child was born at full term with an uneventful delivery and was said to be normal. He was fed a formula after the first month and was weaned at the age of 12 months. He had diphtheria at the age of 1 year. The child's mother stated that he had breathed rapidly always. One week prior to his admission a "cold" developed, with coryza and a cough, and he appeared drowsy. Three days later he was feverish ; the cough was worse, and his respiration became more rapid. Tympany over the right lung two days before admission suggested pneumothorax to the attending physician. Pneumonia also was considered likely.Physical Examination.-Physical examination revealed a fairly well developed but undernourished white boy of approximately 3^years, who was breathing rapidly. The skin was pale, hot and moist. The temperature was 103.6 F., the pulse rate 144 and the respiratory rate 30.The chest appeared symmetrical, but the right side failed to move with respiration. There was flatness over the lower two thirds of the right lung posteriorly and in the right axilla, with considerably diminished breath sounds over this area. Bronchial breathing was heard at the base of the left lung. The pulmonary fields were clear anteriorly, but there was hyperresonance at the apex of the right lung. The maximal cardiac impulse was felt from 2 to 3 cm. inside From the