Rhabdomyosarcoma of the Diaphragm
The following case is presented because of the rarity of tumors primarily in the diaphragm, particularly those originating in voluntary muscle. Peery and Smith1 reviewed the literature and reported a case in March of this year. Theirs was apparently the tenth case on record of a tumor primarily in the diaphragm, the sixth case of a malignant tumor, and the second case of such a tumor arising in voluntary muscle.
A woman, 51 years of age, came to the Clinic in December, 1936, complaining of pain in the neck, fever, and abdominal distress. Two months previously she had had tonsillitis with peritonsillar abscess formation, and chills and fever. This was accompanied by sharp pain in the lower right posterior chest which was not influenced by respiration. Pain also developed in the posterior cervical area. It was constant at first, but was noted later only with a moderate rise in temperature which occurred each afternoon from the date of onset.
The gastro-intestinal symptoms consisted essentially of anorexia for two months, fairly constant nausea without vomiting, and intermittent abdominal distention for two weeks. She had lost seven pounds in weight.
Two ribs on the right side had been fractured a year previously, and a rib resection for empyema had been performed on the left side 18 years before.
Her mother and one aunt had died from carcinoma.
Physical examination on admission revealed weight, 144½ pounds, temperature 99.6° F., pulse 108 beats per minute, and blood pressure 155/78. No diaphragmatic descent. . .