Treatment Challenges and Outcome of Intra-cardiac Lymphoma in a Resource-limited Setting: A Case Report

Abstract

Malignant lymphoma, presenting as primary intra-cardiac mass, is rare in children. Without timely intervention, morbidity and mortality may be high in this condition, particularly when it is associated with pericardial effusion and cardiac tamponade. A case of a 9-year old Nigerian girl with primary cardiac lymphoma associated with pericardial effusion and cardiac tamponade is reported. For reasons of parental financial incapability, the girl received only two of the six recommended courses of systemic chemotherapy following emergency pericardiostomy. She was alive and well for one year but suddenly died at home following the re-emergence of symptoms similar to the initial presentation of the primary neoplastic disease. The response of primary cardiac lymphoma to combination chemotherapy alone is known to be good, thus, it is advocated as the treatment of choice for primary cardiac lymphoma where the resources for cancer treatment are limited and the cost of care is prohibitive. The lack of access to adequate chemotherapy may be the key factor responsible for the poor prognosis and fatality in this case.

Keywords

• Chemotherapy
• Health financing
• Intra-cardiac lymphoma
• Resource-limited setting
• Nigeria