Falkenstern-Ge RF, Kimmich M, Wohlleber M, Friedel G, Ott G and Kohlhäufl M
Pneumothorax ex vacuo is a rare type of pneumothorax which forms adjacent to an atelectatic lobe. Pneumothorax ex vacuo occurs if the underlying lung is unable to expand, for example due to bronchial obstruction under severe pleuramesothelioma. In this situation, the pleural effusion was caused by lung collapse, leading to negative pressure in the pleura which gradually pulled in fluid. The primary problem is not the pleural effusion, but rather the fact that the lung cannot expand. Our patient has severe pleuramesothelioma. The palliative chemotherapy was already initiated. Due to progressive dyspnea, a thoracentesis with implication of pleurX-catheter was performed in this situation.