Spontaneous Hemothorax Revealing a Bronchial Carcinoid Tumor

Abstract

Introduction: Spontaneous hemothorax is an uncommon pathology. The majority of hemothorax is a result of open or closed thoracic traumas.  Thus, spontaneous hemothorax caused by a carcinoid tumor is an exceptional case that has only been reported once in the literature.Case report: We report the case of a 58 years old Moroccan male patient. The patient was admitted to the emergency room for a sudden left chest pain associated with dyspnea and low abundance hemoptysis. The chest radiography revealed an opacity of the left lower lobe. Chest CT scan revealed an effusion of an average abundance mottled with pulmonary atelectasis. Flexible bronchoscopy was not conclusive. After the thoracentesis failure, a thoracotomy exploration was decided. Spontaneous hemothorax and the presence of a 5cm tumor etiology were intraoperative. Two surgical biopsies were performed with inconclusive extemporaneous readings. A left pneumonectomy with lymphadenectomy was decided to ensure both hemostasis and oncologic resection. The results of histological examination and immune-histo-chemical study were in favor of a carcinoid tumor. The post-operative results were simple.Conclusion: Spontaneous hemothorax due to the atypical carcinoid tumor is an extremely seldom situation making this case only the second one to be reported in the literature. The peripheral location of the tumor, and the presence of passive pulmonary atelectasis and blood clots, were the factors that made the diagnosis difficult.