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In 1994, we published a rare case report of a left sided pneumothorax caused by a mesenchymal cystic hamartoma (MCH) in this journal (Thorax 1994;49:1175–6).1
After a follow-up of 23 years, the same patient was referred for a left sided pain and thoracic mass at age 36 years. At age 14 years, a left sided thoracotomy was performed for recurrent pneumothorax followed by lobectomy of the left lower lobe in which a MCH was diagnosed.1 Now his symptoms started almost 1 year before referral. Analysis showed an inhomogeneous mass in the lower left thoracic cavity with metabolic activity on the F-18-fluorodeoxyglucose positron emission tomography-PET scan. Follow up CT-scans showed slow progression (figure 1) and CT-guided biopsy showed a monophasic malignant tumour consisting of spindle cells, immunohistochemically positive for vimentin and epithelial membrane antigen (EMA) …