[Melanoma bronchopulmonary metastasis concerning 2 cases]

Melanoma is a malignant melanocytary tumor that has a great metastatic potential. Bronchopulmonary metastases are the most frequent ; estimated up to 33% according to the review of literature. The authors report two observations of melanoma bronchopulmonary metastases. The first observation concerns a 61 year-old patient, with as antecedent a melanoma of the thigh confirmed by exersis biopsy and who shows two years later a bronchic syndrome with thoracic pain in a context of general condition alteration. Chest x-ray revealed a retractile opacity of all the right hemithorax associated to a left mediothoracic macronodular opacity. Bronchoscopy detected a tumor obstructing the right bronchus strain whose anatomopathologic exam concluded to a bronchic melanoma. The diagnosis of the melanoma bronchopulmonary metastases of the thigh was thus maintained and the proposed treatment was palliative symptomatic. The second observation concerns a 42 years patient who showed 1 month before had admittance to hospital a bronchic syndrome and thoracic pain in a context of general condition alteration with a naevus of the right cheek of 3 cm in an ulcerous detected a stage melanoma. The chest x-ray found multiple macronodular opacities in baloon-letting out form of tissular density at CT-scan evoking pulmonary metastases. Bronchoscopy revealed a burgeoning tumor witely necrosed at the left basal pyramid. The diagnosis of melanoma bronchopulmonary melanoma of the cheek was maintained and the treatment was symptomatic

[Recurrent pleural fibromatosis revealed by a spontaneous pneumothorax: about one case]

Pleural fibroma, also called benign pleural mesothelio-ma, is a rare tumor not linked to the exposure to "l'amiante", developed through the underpleural conjunctive tissue and whose pathology remains unclear. The authors report the case of a patient, 51 year-old, operated for left solitary pleural fibroma and who shows two years later left thoracic pain with exercise dyspnea with alteration of the general conditions. Chest X-ray and chest CT-scan revealed left hydropneu-mothorax with tissular mass in contact with lung stump and tissular left axillary mass. Punction exsuflation in left basithoracic draws serohematic exsudative lympho-cytary liquid with non malignant cells. Bronchoscopy detected a diffuse 2[nd] degree bronchic inflammation. Lateral left thoracotomy is then carried out and showed pleural tumor of 8 cm in diameter linked to the lung stump and a second necrosed pleural tumor whose ana-tomopathologic study concluded to pleural fibromatosis, with normal follow-up. Through this observation, the authors recall the recidivating character after the surgical resection of pleural fibromas that in certain cases can supervene on a malignant pattern [fibrosarcoma], and also underline that spontaneous pneumothorax can reveal this recidivation and that hypoglycemia, classically a sign associated to these tumors, can be inexistent despite the multiplicity and the important size of the fibromas