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Benign fibrous or pleural mesothelioma are rare tumors that seem to originate in the mesenchyma (subpleural fibromas). They are usually discovered by chance and the prognosis for the patient is favorable after surgery. If the tumors are large, extrapulmonary signs may be present (hypertrophic osteoarthropathy, hypoglycemia). We describe a case of unusually large fibrous mesothelioma of the pleura that presented as superior vena cava syndrome, a complication not described in the literature.

The finding of a double primitive pulmonary neoplasm in the same patient is a fact rarely published, between 0.5 and 3.5% depending on the series, most of them surgical or necropsies series. We present the case of a patient who after being diagnosed of bronchial epidermoid carcinoma and treated with radiotherapy, developed, one year later, a relapsing homolateral pleural effusion due to an oat-cell type carcinoma. We review the incidence of this association in the scientific literature, outlining the difficulty to establish the diagnosis in patients non treated with radical surgery.