Resection of giant benign fibrous mesothelioma of pleura

Localized fibrous mesothelioma of the visceral and parietal pleura are relatively uncommon tumors which can usually be resected without difficulty. Rarely they grow large enough to cause compression of intrathoracic viscera. These giant intrathoracic masses present formidable surgical challenges and require thorough preoperative evaluation. Precise localization of the tumor and assessment of adjacent intrathoracic organs are important. The establishment of histologic diagnosis is ideal but often impossible prior to thoracotomy. The surgical approach is planned to include wide exposure, rapid blood replacement, and the possible use of autotransfusion or cardiopulmonary bypass. Careful anesthetic management and postoperative intensive care are essential. These points are well illustrated in the presented case.