A RESECTED CASE OF GIANT PLEURAL TUMOR WITH SYMPTOMS RELATING TO THE TUMOR

Abstract

Localized primary pleural tumors are relatively rare and are often asymptomatic. Recently we experienced a patient with giant pleural tumor who manifested specific symptoms relating to the tumor such as hypoglycemia and hypertrophic pulmonary osteoarthropathy including arthralgia and clubbed fingers.
A 58-year-old woman was emergently admitted to the hospital because of an attack of hypoglycemia on February 26, 1997. Chst X-ray film revealed an abnormal shadow occupying the left middle lower lung. Chest CT and magnetic resonance imaging (MRI) demonstrated a giant tumor occupying the entire left thoracic cavity. A sternal midline incision, a thoracotomy between the left 3rd and 7th ribs, and an incision of costal cartillage were conducted to remove the tumor. During operation, the dorsal side of the tumor most firmly adhered to the chest wall, and adhesions to the diaphragm, left 6th rib, and a part of left lower lobe of lung were also present. So the definite diagnosis of primary tumor of the pleura parietalis was made. The tumor was 24×16×9.5cm in size and about 2, 900g in weight. Pathologically it was localized firous tumor of the pleura. After the removal of the tumor, hypoglycemia and hypertrophic pulmonary osteoarthopathy disappeared.