[Pericardial effusion in neoplasms and malignant hemopathies in children. Study of 12 cases and pathogenetic...

Pericardial effusion (P.E.) has been described during the course of malignant neoplasms and leukemia, but in children its frequency is not well-known. It is possible by echocardiography to identify very small P.E. M-mode echocardiograms were performed for periodic evaluation of the patients treated by antraciclinic drugs and when P.E. was suspected by the physical examination, chest roentgenogram and electrocardiographic data. A total of 265 echocardiograms were performed in 210 children with malignant neoplasms and leukemia from 1981 to 1985 and 12 cases (5.7%) of P.E. were identified: 7 affected by acute lymphatic leukemia (ALL), 3 Rhabdomyosarcoma, 1 by Wilm's tumor and 1 by Ewing's sarcoma. In all patients was carried out and Ecg, and a chest roentgenogram was performed to evaluate cardiac shadow. Hemoglobin, serum protein and VES values were evaluated to control, respectively, anemia, dysprotidemia and flogistic condition. Pericardiocentesis was played when clinical findings indeed. P.E. was identified in 6 out all cases, 4 affected by ALL and 2 by Rhabdomyosarcoma, during the first clinical approach. Two cases, both affected by ALL, showed large P.E., x-ray enlarged cardiac shadow and typical electrocardiographic findings. The disappearance of the P.E., resulted few days after the beginnings of antiblastic therapy. Four cases were in maintenance therapy: 2 affected by ALL, 1 Ewing's sarcoma and 1 by Rhabdomyosarcoma. The last two showed very large P.E. and pericardiocentesis was necessary: only in patient with rhabdomyosarcoma fluid containing malignant cells was yielded, and reproducing itself one day after.(ABSTRACT TRUNCATED AT 250 WORDS)