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November 8, 1965

The Smallest Tumor Which Causes Sudden Death

Author Affiliations

From the departments of pathology (Dr. Wolf) and medicine (Dr. Bing), Wayne State University School of Medicine, and Receiving Hospital (Dr. Wolf), Detroit.

JAMA. 1965;194(6):674-675. doi:10.1001/jama.1965.03090190096030

PRIMARY MESOTHELIOMA of the atrioventricular (AV) node is a tumor of uncertain origin and an unusual cause for complete heart block accompanied by Adams-Stokes attacks and sudden death. A majority of these lesions are classified as primary mesothelioma of the AV node, originating from misplaced epicardial tissue. The first case was reported in 1911 by Armstrong and Mönckeberg,1 only a minimal number of cases have been reported since then. We recently observed a similar case.

Report of a Case  A 67-year-old white man was admitted to the hospital because of severe dyspnea after exertion of a few hours' duration. Approximately four years previously, the patient had begun to experience mild exertional dyspnea associated with substernal chest pain radiating to the left arm. There was no cough or hemoptysis. He complained of a gradual gain in weight during the past few months, with swelling of the abdomen, scrotum, and legs.