Pediatric Pulmonology 49:E7–E9 (2014) Case Report Cardiac Fibroma, Anomalous Pulmonary Venous Course, and Persistent Pneumonia in a Patient With Gorlin Syndrome Benjamin T. Kopp, MD, 1 * Kerry L. Rosen, MD, 2 Julie C. O’Donovan, MD, 3 and Shahid Sheikh, MD 1 Summary. We report the unusual case of a child referred for persistent pneumonia and possi- ble pulmonary nodules who was found to have a cardiac fibroma and diagnosed with Gorlin syndrome. Pulmonologists should be aware of the potential for vascular anomalies associated with this syndrome as well as the risk for pulmonary metastases from primary skin tumors. Pediatr Pulmonol. 2014; 49:E7–E9. ß 2012 Wiley Periodicals, Inc. Key words: cardiac fibroma; pulmonary veins; persistent pneumonia. Funding source: none reported. INTRODUCTION Persisting pediatric lung opacities are common and have a vast differential including bacterial, viral and fungal infections, pulmonary nodules, foreign bodies, primary or secondary tumors, immunodeficiencies, and vascular anomalies. The most commonly reported etiol- ogy for pediatric lung nodules is calcified granuloma- tous disease, usually fungal in nature. Approximately 50% of fungal pulmonary nodules are asymptomatic at discovery as reported in a large case series. 1 We report the case of an 8-year-old male referred for persisting pneumonia and concern for pulmonary nodules that was found to have a cardiac fibroma and an anomalous course of his pulmonary veins and was diagnosed with Gorlin syndrome. In this case report we will highlight the existing literature on pulmonary findings in Gorlin syndrome as well as a novel description of pulmonary venous abnormalities in this syndrome. CASE REPORT An adopted 8-year-old male presented to the pulmo- nary clinic for evaluation of lung nodules following a pneumonia diagnosed on chest radiograph 2 months prior. At that time he completed courses of amoxicillin and azithromycin with resolution of respiratory symp- toms. A follow up visit to his primary physician a month later showed a persisting perihilar fullness concerning for persisting pneumonia and he was placed on amoxicillin-clavulanate. He then developed right jaw swelling and pain 1 week prior to presentation and a dental evaluation revealed a known cavity, but no explanation for pain in his jaw. Past medical history was significant for well-controlled attention deficit hyperactivity disorder and surgical repairs of a hernia and pyloric stenosis. There were no prior pneumonias 1 Department of Pediatrics, Section of Pediatric Pulmonology, The Ohio State University, Nationwide Children’s Hospital, Columbus, Ohio. 2 The Heart Center, Nationwide Children’s Hospital, Columbus, Ohio. 3 Department of Pediatric Radiology, Nationwide Children’s Hospital, Columbus, Ohio. Conflict of interest: None. The authors have no financial disclosures or grants for this manuscript. *Correspondence to: Benjamin T. Kopp, MD, Nationwide Children’s Hospital, Section of Pulmonary Medicine, Columbus, 43205 OH. E-mail: benjamin.kopp@nationwidechildrens.org Received 19 September 2012; Accepted 30 October 2012. DOI 10.1002/ppul.22726 Published online 28 November 2012 in Wiley Online Library (wileyonlinelibrary.com). ß 2012 Wiley Periodicals, Inc.