Fibroma of the Visceral Pleura

Abstract

Intrathoracic fibromas are rare tumours, but as might be expected they have been described in many different situations within the chest in relation to areas of connective tissue. In a personal series of 198 primary intrathoracic neoplasms, excluding carcinoma of the lung and oesophagus, Harrington (1950) encountered 13 fibromas or lipofibromas, all of which arose in the posterior mediastinum, but most of those which have been fully described appear in single case reports. Study of the available literature suggests that these tumours may be classified in four groups depending upon their position. Some have been found in the larger bronchi and occasionally diagnosed after biopsy through a bronchoscope. Others have been identified in relation to the parietal pleura, although some of these are undoubtedly fibrous tumours of neural origin. The third gi oup occurs in the mediastinum and the fourth comprises those which appear to arise beneath the visceral pleura. The growth may assume giant size before the onset of symptoms referable to the chest, and may obtain additional blood supply through adhesion to neighbouring structures. It is then difficult-and sometimes impossible-to define its origin. Clagett and Hausmann (1944) claim the biggest fibroma yet removed from the chest, a mass weighing 5 kg., filling the lower part of the right pleural cavity and extending behind the heart to the left side. This was so densely adherent that it was not possible to decide whether it arose beneath the visceral or parietal pleura. This paper is intended to describe our findings in some examples which fall in the fourth group, i.e., those which we believe arise in close relation to the visceral pleura. CASE REPORTS CASE 1.-The patient was a man of 62 years of age when surgical operation was advised in 1947. At the age of 13 he developed right-sided pleurisy. When he was 21 years of age he spent two months in a sanatorium *Based on a paper read to the Thoracic Society at the Royal College of Surgeons in London on

Angiography in the Management of Intra- and Supra-Sellar Tumours

“…The typical picture has been described by Claggett et alii (1952) and by Price- Thomas and Drew (1953). Females are more commonly affected than males and the disease is commonest in the sixth decade.…”

Giant fibromyxoma of the parietal pleura.

“…Sometimes finger clubbing and the joint pains of hypertrophic pulmonary osteoarthropathy are the presenting symptoms (Clagett et al, 1952;Thomas and Drew, 1953). Respiratory symptoms, notably shortness of breath, may as in this patient arise from the bulky tumour interfering with pulmonary expansion or causing mediastinal displacement.…”

Hypertrophic pulmonary osteoarthropathy in association with pulmonary metastases from extrathoracic tumours

“…None of these patients had clinical evidence of pulmonary osteoarthropathy; one had periosteal new bone and 34 had clubbing of the fingers. Fibrous tumours of the pleura are associated with pulmonary osteoarthropathy in 66% of cases (Clagett, McDonald, and Schmidt, 1952;Price Thomas and Drew, 1953;Benoit and Ackerman, 1953).…”