[Recurrent pleural effusion revealing a left atrial myxoma]

A 43 years old woman without any medical history was admitted 8 months before with a right pleural effusion, considered and treated as tuberculous pleurisy, with a good evolution. The recurrence of the right pleural effusion, the reappearance of chest pain, anxiety and nocturnal dyspnea elicited new investigations. The pleural fluid had a low protein content, pleural biopsy was irrelevant. CT scan, bronchoscopy and abdominal ultrasound were of no diagnostic value. Cardiac ultrasound revealed a large left atrial tumor, determining mitral stenosis. The patient underwent surgery, the tumor was excised, the histologic type was myxoma. Three weeks after surgery a right pleural effusion was noticed, this time with high protein content and resolving with non-steroid anti-inflammatory treatment. Pleural effusion never reappeared in the following 6 months. Discussions are made upon the mechanism which determined the pleural effusion in this case.