RESUMO
Empyema necessitans is a rare condition where tuberculosis is the most common cause. It can be found in both immunocompromised and immunocompetent patients, especially in endemic areas. We report a case of a 29-year-old male from North Africa, with an enlarging mass on the right thoracic wall. Imaging, particularly CT showed a cystic lesion in the right chest wall communicating with homolateral pleural effusion, compatible with empyema necessitans. It also showed patterns of pulmonary tuberculosis in the right upper lung. Treatment of empyema necessitans is a combination of medical and surgicaltreatment. Our patient underwent a surgical treatment consisting of flattening of the empyema with a Gene X-pert study of the fluid and the shell, followed by an anti-TB treatment. Anatomopathology confirmed the diagnosis of caseo-follicular tuberculosis.
Assuntos
Antibacterianos/uso terapêutico , Fístula Brônquica/terapia , Drenagem , Empiema Pleural/terapia , Doenças Pleurais/terapia , Pneumonectomia/efeitos adversos , Fístula do Sistema Respiratório/terapia , Procedimentos Cirúrgicos Torácicos , Antibacterianos/efeitos adversos , Fístula Brônquica/diagnóstico por imagem , Fístula Brônquica/etiologia , Fístula Brônquica/mortalidade , Drenagem/efeitos adversos , Drenagem/mortalidade , Empiema Pleural/diagnóstico por imagem , Empiema Pleural/etiologia , Empiema Pleural/mortalidade , Humanos , Doenças Pleurais/diagnóstico por imagem , Doenças Pleurais/etiologia , Doenças Pleurais/mortalidade , Pneumonectomia/mortalidade , Valor Preditivo dos Testes , Fístula do Sistema Respiratório/diagnóstico por imagem , Fístula do Sistema Respiratório/etiologia , Fístula do Sistema Respiratório/mortalidade , Fatores de Risco , Procedimentos Cirúrgicos Torácicos/efeitos adversos , Procedimentos Cirúrgicos Torácicos/mortalidade , Resultado do TratamentoRESUMO
BACKGROUND: Neuroendocrine tumors are a large group of tumors with a wide spectrum of behavior, affecting mainly the digestive system and the lung. The thymus is very rarely affected. CASE PRESENTATION: A 28-year-old Arab woman presented with chronic chest pain and dyspnea. A computed tomography scan showed a huge anterior mediastinal mass invading neighboring structures. A mediastinotomy was performed with biopsies of the mass. Pathological findings were consistent with a thymic large cell neuroendocrine carcinoma. CONCLUSIONS: The occurrence of a large cell neuroendocrine carcinoma in the thymus, especially in young people, is extremely rare. In this current report, we discuss the clinicopathological issues of this rare tumor according to recent literature data.
