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

ABSTRACT

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