Tumors of the Heart. Ii. Report of a Secondary Tumor of the Heart Involving the Pericardium and the Bundle of His With Remission Following Deep Roentgen-Ray Therapy

T H E first paper of this series x included a description of the first reported case of a primary tumor of the heart recognized before death in a patient in whom there was no previous knowledge of tumor elsewhere in the body.f The diagnosis was simple and logical, the same reasoning being applied to a rapidly recurring sanguinous pericardial fluid that has been applied many times to a similar pleural effusion. In that report it was suggested that roentgen-ray therapy might have helped the patient had it been tried early. Curiously enough, as often happens in the practice of medicine, we soon had the privilege of ob-serving a case of a metastatic tumor of the heart which responded promptly to roentgen-ray therapy, though metastases elsewhere resulted in death five months later. There have been a number of cases of metastatic tumors of the heart which were diagnosed before death,8 but so far none have been reported showing the effect of deep roentgen-ray therapy on these tumors. In this and doubtless in all the other cases, once the diagnosis was made it seemed useless to try any known form of treatment. However, in our case the patient was in great dis-tress as a result of a very marked pericardial effusion (figure 1), and though we