Primitive squamous-cell carcinoma after extrapleural pneumothorax for active tuberculosis

Squamous-cell carcinoma into an extrapleural pneumothorax for active tuberc ulosis was incorrectly diagnosed as late tubercular empyema. Right axillary thoracostomy was carried out to drain large dense effusion decompressing t he brachial plexus and the sympathetic chain with symptomatic release. Surg ical biopsy of the extrapleural sac allowed to identify two different tissu es: normal epithelium similar to epidermis and nodular fragments composed o f well-differentiated squamous carcinoma. The cause of this tumour is not c lear: probably the carcinoma arose from normal epidermis carried in the ext rapleural cavity during multiple air-refills to maintain the therapeutic pn eumothorax. (C) 2001 Elsevier Science B.V. All rights reserved.