Sir .—We noted with interest the report by Dunnigan et al (Journal1981;135:420-421) of a child with left atrial myxoma. Left atrial myxoma is a rare lesion in the pediatric age group, with high morbidity and mortality if undiagnosed. The tumor may be associated with constitutional symptoms, with peripheral embolization, and with obstruction of left ventricular inflow. The clinical diagnosis frequently is difficult because of its confusing initial appearance and its protean manifestations. The majority of pediatric patients initially were thought to have acute rheumatic fever, mitral valve disease, infective endocarditis, or collagen vascular disorders. The purpose Subxiphoid four-chamber view demonstrates large tumor (t) arising from left atrium (la) between pulmonary veins and traversing mitral valve (m); Iv indicates left ventricle. of this letter is to mention another case of this unusual entity and to illustrate the role of two-dimensional echocardiography in its diagnosis. We recently saw a 14-year-old boy