Methotrexate is the frequently used drug with a variety of dosage depending on the type of malignancy and route of administration. The route of administration can be oral, intramuscular, intravenous, or intrathecal. Most common toxicities after its administration: Nausea Vomiting Mucositis A rare form of pleurisy and pneumonitis with or without pericardial involvement with immune-mediated serositis Experiencing isolated pericardial effusion through toxicity of methotrexate is a rare entity.

There are only two cases in literature studies: A patient with Hydatidiform mole who received low-dose A patient with Psoriasis treated with a small dose Here is the case of a 7-year-old boy who experienced toxicity following high-dose of methotrexate (5 g/m 2 per cycle). Case: A 7-year-old boy with T-cell lymphoblastic lymphoma was treated with chemotherapy on the basis of BFM protocol. The case…