Neumotórax de repetición como presentación de sarcoma sinovial pleuropulmonar / Pleuropulmonary synovial sarcoma presenting as recurrent pneumothorax

Los sarcomas sinoviales son neoplasias de tejidos blandos, afectan a adultos jóvenes y de mediana edad, no existen diferencias con respecto a la distribución por sexo. Se localizan en el 90% de los casos en las extremidades. El sarcoma sinovial pleuropulmonar primario (SSPP) es muy poco frecuente, constituye el 0,1% de los tumores pulmonares. Frecuentemente se manifiesta con tos y/o hemoptisis, el neumotórax es una forma poco común de presentación. Son tumores con mal pronóstico y presentan alto riesgo de recidivas locales. Las mejores supervivencias están relacionadas con el tratamiento quirúrgico, siendo la resección completa tumoral el principal factor pronóstico. El tratamiento de elección es quirúrgico, seguido de quimioterapia, radioterapia o ambas. Presentamos el caso clínico de un sarcoma pleuropulmonar primario que clínicamente se manifestó como neumotórax (AU)

Synovial sarcomas are a soft-tissue neoplasms which affects young and middle-aged people, with no difference in distribution between sexes. They are located in the extremities in the 90% of the cases. Pleuropulmonary primary synovial sarcoma SSPP is very unusual, constitutes 0.1% of pulmonary tumors. In most cases the SSPP present themselves with cough and / or hemoptysis whereas pneumothorax is an uncommon form of presentation. Prognosis is usually poor, they present high risk of local recurrence. The survival rate depends on the surgical treatment, being the complete tumor resection the main predicting factor. Surgery is the treatment of choice followed by chemotherapy, radiotherapy or both. We present a case report of a pleuropulmonary synovial sarcoma which presented with pneumothorax (AU)

Ptosis palpebral asociada a neurofibroma mediastínico posterior. Tratamiento quirúrgico / Ptosis palpebral associated to mediastinal neurofibroma after surgical treatment

Los neurofibromas son tumores neurógenos originados a partir de las células de Schwann y de los fibroblastos de las vainas nerviosas de los nervios periféricos. Entre el 40 y el 60% de los tumores de mediastino posterior son neurofibromas y schawnnomas. El schwanoma es el más frecuente. Su evolución es lenta, ello explica el gran tamaño observado en el momento del diagnóstico en algunos casos, lo que justifica la sintomatología por compresión. Presentamos el caso clínico de un neurofibroma mediastínico posterior que se inició clínicamente con dolor pleurítico y ptosis palpebral (AU)

Neurofibromas are neurogenic tumors originated from Schwann cells and the fibroblasts of the peripheral nerve sheaths. From 40-60% of the posterior mediastinal tumors are neurofibromas and schawnomas. The schwannoma is the most frequent. Its development is slow, which explains the large size observed at the time of diagnosis in some cases. This explains the compression symptoms. We present the clinical case of a posterior mediastinal neurofibroma that began clinically with pleuritic pain and palpebral ptosis (AU)

Clinical-therapeutic management of thoracoscopy in pleural effusion: a groundbreaking technique in the twenty-first century

INTRODUCTION: The aim of this study was to investigate the effectiveness of thoracoscopy in the diagnosis of non-affiliated pleural effusions (PE). MATERIAL AND METHODS: A five-year prospective study including data from 110 patients that were clinically diagnosed as benign (14.5%), malign (34.5%) and non-affiliated (50.9%). PE in patents without oncology disease and negative biopsy or cytology were considered as benign. Malignant diagnosis was established according to a pleural biopsy, compatible cytology and/or clinical features. Remaining cases were considered as non-affiliated. Thoracoscopy was done under local anaesthesia and sedation. RESULTS: Thoracoscopy confirmed previous clinical diagnosis of benignity and malignity. Regarding non-affiliated patients, 30.35% were diagnosed after thoracoscopy as unspecific pleuritis, 17.86% mesothelioma and 1.79% pleural tuberculosis (TBC). The other 48.21% of patients reported as non-affiliated were diagnosed with pleural carcinoma. Statistical analysis did not reveal differences between frequencies analysed. CONCLUSIONS: Our results indicate that thoracoscopy is a cost-effective and reliable technique for obtaining histological diagnosis in PE and also allows a directed pleurodesis if indicated (AU)