• Soheila Zareifar, Sirous Cheriki, Maral Namdari, Mohammadreza Farahmandfar, and Ahmad Jannati.
• Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ; Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, Iran.
• Iran J Pediatr. 2012 Mar 1;22(1):117-20.

BackgroundAcute lymphoblastic leukemia (ALL) is the most common malignancy diagnosed in children. Extramedullary leukemia including hepatosplenomegaly, lymphadenopathy, and mediastinal mass are the clinical presentations of T-cell ALL. Pericardial effusion and atrial mass are rare presentations of pediatric leukemia.Case PresentationWe report a 15-year-old girl with T-cell ALL, who presented initially with pericardial effusion and cardiac tamponade and subsequently developed right atrial mass. The mediastinal and right atrial masses were excised by surgical procedure as a treatment strategy for prevention of arrhythmia and sudden death.ConclusionT-cell ALL can present with pericardial and mediastinal involvement as an initial manifestation. Pericardiocenthesis and systemic anticancer chemotherapy without local chemotherapy should be considered in these cases.

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