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DISCUSSION: Pericardial fat necrosis is often a uncommon, self-limited, and benign bring about of acute chest pain. Pericardial fat necrosis as a trigger of acute chest discomfort was 1st reported in 1957, considering the fact that that time only 26 instances have already been reported within the literature. Pathogenesis is unclear, but obesity is viewed as a predisposing danger element. Ahead of the advent of CT scan, diagnosis was based on abnormal chest radiograph and surgery. Existing imaging technologies permit for diagnosis by CT scan and/or MRI. MRI findings of fat necrosis could be variable based on the pathological stage of fat necrosis. Pericardial fat necrosis is actually a self-limited disease and treated with NSAID therapy.PERITONEAL MESOTHELIOMA WITH PERSENTATION OF DERMATOMYOSITIS Manivel Eswaran 1,2 ; Muhammad Ansar 1 . 1 Geisinger Medical Center, Danville, PA; 2Temple University, Philadelphia, PA. (Tracking ID #1641739) Learning OBJECTIVE 1: Dermatomyositis can present with peritoneal mesothelioma Finding out OBJECTIVE 2: Peritoneal mesothelioma can present without the need of substantial exposure to asbestos CASE: 64 year old woman with past medical history of hypertension presented for the clinic with rash in her chest which was spread in classic shawl like pattern. She had related fat reduction and loss of appetite. Initially it was suspected to become allergic phenomenon and was treated conservatively. It didn't get much better and provided her related symptoms dermatomyositis was diagnosed and underlying malignancy was suspected. This was followed with a CT abdomen offered her symptoms of abdominal discomfort. CT showed mass in abdomen and it was suggestive of ovarian cancer. She was supposed to become noticed by Gynecology oncology and planned for debulking surgery. Her CA 125 was elevated. Within the meantime she developed symptoms of dysphagia and her symptoms got worse for the point she was not in a position to tolerate something orally including liquids. As a result of her inability to eat or drink she was hospitalized for hydration. She got upper gastrointestinal endoscopy and 	 it was a regular study. Her symptoms were suspected to be from dermatomyositis and was began on high dose steroids. Also chest xray was completed it was reported regular. Later on on account of progression of her symptoms she was taken to operating space and got her debulking surgery with suspicion of ovarian cancer. She was planned to be started on chemotherapy for suspected ovarian cancer. Biopsy benefits came back soon with diagnosis of peritoneal mesothelioma. Discussions have been held with her about palliative chemotherapy but she refused therapy and opted for palliative care. She was discharged house on palliative measures. DISCUSSION: Peritoneal mesothelioma [http://www.ncbi.nlm.nih.gov/pubmed/18204824 18204824] is really a aggressive tumor which has poor prognosis. Only 50   on the sufferers with peritoneal mesothelioma have exposure to asbestos. As a [https://www.medchemexpress.com/BMN-673.html BMN-673] consequence of its vague symptoms it is typically diagnosed in later stages. Paraneoplastic syndromes with peritoneal mesothelioma is rare. Description of dermatomyositis in association with peritoneal mesothelioma was restricted in literature with few instances. That is one of the case with the one of a kind presentation of dermatomyositis and dysphagia with underlying peritoneal mesothelioma. Remedy for dermatomyositis connected to cancer is always to treat the underlying trigger. In this situation resection of tumor will provide benefit. Radical resection with intraperitoneal hyperthermic perfusion is regarded the common remedy fo.