Low grade fibromyxoid sarcoma is a rare entity accounting fore1% of all adult cancers mostly identified in lower extremities (thigh), as well as occasional reports of sarcomas in axillae, shoulder, mediastinum, inguinal region. Primary fibromyxoid sarcoma of the lung is extremely rare phenomenon, to date, reported fewer than 10 times.

A case of congenital pulmonary stenosis, ventricular septal defect, and ruptured aortic sinus aneurysm in a 71-year-old man is reported. We have been unable to find an account of any similar case.Case Report At 28 years of age the patient had complained of moderate (grade III) dyspncea on exertion and subsequently this had limited him to light work. He had remained well until a few months before admission, when he had noted swelling of his feet and legs for the first time. Despite treatment by his doctor the aedema had persisted and he was admitted to hospital on February 4, 1960. Clinical examination showed a youthful looking man in spite of his 71 years, with pitting cedema of both feet and legs to the level of the knees. He appeared pale and lightly jaundiced. There was increased filling of his neck veins to the level of the angle of the jaw in the sitting position. The pulse was 80 a minute and pulsus bigeminus was present. The blood pressure was 155/70. The cardiac impulse was palpable in the fifth intercostal space at the anterior axillary line. Systolic retraction occurred over the apex and was accompanied by a precordial heave. A single second sound was clearly heard over the second left intercostal space about 5 cm. from the centre of the sternum. A very loud, harsh, systolic murmur covering the first heart sound was heard maximally in the third left intercostal space, extending from the left sternal edge to the mid clavicular line and this was accompanied by an obvious systolic thrill. The murmur was not heard at the apex and finished abruptly in the second left intercostal space: it continued into late systole, but seemed to finish before the second sound. A very soft diastolic murmur was also present over the third intercostal space 5 cm. from the left border of the sternum.Examination of the patient's remaining systems did not show any abnormality, apart from the signs of a right-sided pleural effusion and an enlarged liver. The serum bilirubin was 1 8 mg. per 100 ml. with a positive direct Van den Bergh reaction. Further investigations including analysis of the urine, blood urea, a full blood count, erythrocyte sedimentation rate, and additional liver function tests showed no abnormality. A chest X-ray confirmed the presence of a right-sided pleural effusion and disclosed patchy consolidation in the right lower zone. A cardiogram showed non-specific changes: there was sinus rhythm with ventricular premature beats and the transitional zone was rotated to the left and the T waves were of low voltage in all leads.The patient died seven days after admission. Death was due to bronchopneumonia and heart failure. Post-mortem Findings. A large right pleural effusion, pulmonary oedema, and right-sided bronchopneumonia were found. The kidneys, spleen, and liver showed signs of venous congestion. Diverticulosis of the colon was present.The heart was greatly enlarged (weight 720 g.). An aneurysm of the right coronary sinus had ruptured into the conus of the right ventricle between the right and left posterio...

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