Primary Mesothelioma Of the Pericardium

Abstract

Mesothelioma of the pericardium is an uncommon tumor at any age but has not been reported in infancy. Of the 30 cases recorded in the English literature 1-9 the patients vary in age from 8 to 79 years with the greatest incidence in the third and fourth decades. This case is reported because it represents the earliest known occurrence of such a tumor and delineates another cause of cardiac enlargement in the very young.The patient, a 20-month-old white male, was apparently in good health until six months prior to admission when he developed anorexia and failed to gain weight. Three months prior to admission he began to have episodes of palpitation and dyspnea which progressed over the following months. During this time he was treated for "asthma and bronchitis" without improvement. Two days prior to admission, he became severely dyspneic, perspired excessively, and wheezed audibly. A chest film revealed a "massive heart," and fluoroscopy, minimal pulsations of the left ventricle. A tentative diag¬ nosis of fibroelastosis was made. The child was digitalized and referred to Vanderbilt University Hospital for further investigation.Physical examination revealed a temperature of 99.8F (37.7 C), a pulse of 160, respirations of 60, and blood pressures of 100/70 mm Hg in the arms and 100/60 mm Hg in the legs. He was a severely dyspneic, fretful infant with cyanotic lips and nailbeds. There were flaring of the alae nasae and