A supposed primary and cortico-sensitive pleuropericarditis in a 33-year-old woman with an apparent recovery of 9 months, revealed an esophageal leiomyosarcoma with a fatal issue following tumoral and purulent invasion of the mediastinum with an esophagobronchial fistula. Pericardis of tumoral origin may appear as a benign cryptogenetic affection sensitive to corticotherapy. Acquired esophagotracheobronchial fistulae are usually of neoplastic origin and the prognosis is extremely severe, survival being rarely more than three months. 69 cases of esophageal leiomyosarcoma have been reported in the published literature, but survival was prolonged in some patients treated surgically. Investigations for possible esophageal lesions should be conducted in all cases of pericarditis of unknown origin.
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