Giant Fibrous Tumor Misdiagnosed as Traumatic Hemothorax

Abstract

Solitary fibrous tumors of the pleura are neoplasms of the mesenchymal tissue of the pleural mesothelium. The most frequent symptoms are dyspnea, coughing and chest pain. A 45-year-old female patient presented after a thoracic contusion. A radio-opaque image was evidenced on chest X-ray. At the initial hospital, a hemorrhagic fluid was aspirated at thoracocentesis and the patient was transferred to our hospital with diagnosis of traumatic hemothorax. A thoracic CT showed a tumoral formation filling two-thirds of the left hemithorax. The transthoracic biopsy finding was compatible with a fibrous tumor. The patient was taken for surgery and the large pleural tumor was excised. In conclusion, a large pleural fibrous tumor was initially mistaken for hemothorax. A CT-scan revealed the tumoral nature of the thoracic opacity.

Indications and complications of tube thoracostomy with improvised underwater seal bottles

“…This complication can be avoided if more elaborate investigations like computer tomography scan are done as similar misdiagnoses have been reported previously. [11] The two cases of wrong placement involved the extrapleural placement by a consultant which required an exploratory thoracotomy to detect and intraperitoneal placement by a junior resident. It is however noteworthy that no mortality occurred related to the procedure as this is not uncommon.…”

Solitary Fibrous Tumour of the Pleura Presenting as a Spontaneous Massive Haemothorax

“…Less frequently the causes of spontaneous haemothorax may include coagulopathies, vascular ruptures, endometriosis, and neoplasias [ 8 ]. In patients, affected by SFTP, anecdotal cases of haemothorax have been described [ 5 – 7 ]. However, massive bleeding, requiring emergency surgical treatment, is to be considered an extremely rare event.…”

“…In a few cases serous pleural effusion may also be associated with SFTP. To the best of our knowledge, SFTP presenting as a spontaneous haemothorax has been very rarely described in the literature [ 5 – 7 ]. This report describes the case of a 38-year-old woman admitted to our Department of Thoracic Surgery for a right massive spontaneous haemothorax.…”