[An unusual diagnosis of post-traumatic hemothorax]. / Hémothorax post-traumatique révélant un mésothéliome pleural malin.

We report the case of malignant pleural mesothelioma revealed by a post-traumatic hemothorax.

[Pyothorax in pneumonectomy cavity. Apropos of 24 cases]. / Les pyothorax sur cavité de pneumonectomie. A propos de 24 cas.

AIM OF THE STUDY: Describe as series of post-pneumonectomy empyema episodes, with or without bronchial fistula treated at the department of Thoracic Surgery, University of Ibn Sina, Rabat, Morocco. PATIENTS, METHOD AND RESULTS: Twenty-four patients with post-pneumonectomy pyothorax cared for between 1991 and 2000 were reviewed retrospectively. There were 15 men and 9 women, mean age 34 years. Pneumonectomy was indicated for tuberculous pyothorax and destroyed lung (n = 8), 8 destroyed lung (n = 8), pulmonary aspergilloma (n = 2), pulmonary hydatidosis (n = 2), bronchial dilatation (n = 2), lung cancer (n = 1), and bullet wound (n = 1). The patients were divided into two groups according to presence or absence of bronchial fistula: group 1, 19 patients with without bronchial fistula, and group 2 5 with bronchial fistula. Fourteen patients in group 1 (73.7%) achieved definitive cure, 12 after drainage and washout (63%) at mean delay of 45 days and 2 after drainage and washout with thoracoplasty. Five patients did not respond to hospital drainage and washout and remained under definitive ambulatory drainage as they declined further surgical treatment. One death occurred in this group. Two patients in group 2 (40%) achieved definitive cure, one after daily aspiration, and the other after thoracoplasty. Two fistulae in one patient were treated with nitratage. For this patient, we also attempted revision of the bronchial stube via posterior throacotomy, the closure of the bronchial fistula using an intercostal muscle flap associated with thoracoplasty. All these methods failed. There were two deaths in this group. CONCLUSION: Sixteen patients were definitively cured (66.6%). Eight patients (33.3%) remain in a chronic condition. Patients with pyothorax on a pneumonectomy cavity should be managed in specialized centers before reaching the chronic stage. Thoracomyoplasty with preparation of the cavity by thoracostomy should be proposed.

[Myxoid liposarcoma of the mediastinum: a case report]. / Liposarcome myxoïde du médiastin. A propos d'un cas.

We describe a mediastinal myxoid liposarcoma in a 47-year-old man who developed recurrent lung infection, treated by surgery associated with radiotherapy. The report of this case and a review of literature bring the authors to outline the epidemiological, clinical and therapeutic profile of this rare tumor.

[Cystic lymphangioma of the mediastinum. Seven cases]. / Les lymphangiomes kystiques du médiastin. A propos de 7 cas.

Cystic lymphangioma of the mediastinum is an uncommon vascular tumor frequently discovered incidentally on chest x-ray exams. Radiology (CT and MRI) may suggest the diagnosis and allow an assessment of the operatives difficulties, but histology of the surgical specimen is required for precise diagnosis. Complete resection is the only treatment; in some patients resection was incomplete because of the infiltrating character of these tumors, leading to recurrence. We report seven cases of mediastinal localization with a review of literature.