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Rhinocerebral mucormycosis is a fungal diseases that has a 50% mortality. Its occurrence has increased, possibly because of greater use of chemotherapeutic agents that mya compromise the immunologic defenses of the host or alter the normal flora. The earliest signs, ulceration and pain, may appear in the mouth. In the patient described in this report, the autopsy showed that mucormycosis had entered the brain cells.

Primary tumours and cysts of the diaphragm are rare. In a review of the literature Clagett and Johnson (1949) were able to record 30 cases, to which they added four of their own. Of these cases, 18 were malignant and 16 were benign.Primary cysts constituted only a very small proportion of the cases, and in recording a case of mesothelial cyst of the diaphragm Aufses and Oseasohn (1949) stated that they were only able to find records of five other primary cysts in the literature.We have recently encountered a case of mesothelial diaphragmatic cyst; a second almost identical case which was under the care of Mr. Geoffrey Flavell, of the London Hospital, is also reported by his courtesy.CASE REPORTS Case 1.-W. B., a man aged 41, was radiographed when a mass radiography unit visited the factory in which he worked. He had no complaints. Radiographs (Figs. 1 and 2) revealed a small rounded opacity associated with the antero-medial part of the right diaphragm. A diagnostic pneumoperitoneum was carried out as it was thought that the most likely diagnosis was a small liver hernia, and this demonstrated clearly (Fig. 3) that the lesion was in or above the diaphragm, the former appearing more likely, as the outline of the diaphragm appeared to enfold the tumour. As no precise diagnosis could be established, thoracotomy was advised and accepted.On October 31, 1950, the right chest was opened through the bed of the seventh rib. The pleura was completely free of adhesions. In the anterior part of the diaphragm about two inches from the anterior chest wall and from the pericardium lay a tense, bluish cyst, the size of a hen's egg, covered by diaphragmatic pleura and having muscle fibres of diaphragm splayed out over it. The overlying pleura was incised and the cyst shelled out without difficulty, leaving a defect some 2 in. in diameter in the diaphragmatic musculature, in the floor of which intact peritoneum was visible. This defect was closed with interrupted silk sutures and the chest closed without drainage. The postoperative course was uneventful, the patient being discharged home on the tenth day.Dr. G. R. Osborn reported that the cyst from the diaphragm measured about 2 cm. in diameter. Microscopically it was of the simple chylous type; the lumen was lined with a single layer of endothelial cells which occasionally had rudimentary papillary projections. Outside this there was a little areolar connective tissue and then skeletal muscle fibres from the diaphragm.

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