The clinical findings of an upper abdominal mass, abdominal bruit, and congestive heart failure in a neonate invariably suggest a diagnosis of hemangioma of the liver. Abnormal arteriovenous communications have rarely been described in other abdominal tumors.1 We have recently had the opportunity to care for an infant with a congenital mesoblastic nephroma who developed congestive heart failure during the first 12 hours of life. An arteriovenous shunt through the highly vascular renal tumor appeared to play an important role in the pathogenesis of this patient's cardiac decompensation.
Report of a Case.—A 2,960-g male infant was born to a gravida 3, para 2, abortus 0 mother following a 35-week gestation complicated by polyhydramnios. Apgar scores at one and five minutes were 6 and 9, respectively. Pulse rate was 158 beats per minute; respirations, 48/min. There was no cyanosis or grunting. On the initial physical examination, a large right