Emergent salvage surgery for massive hemoptysis after proton beam therapy for lung cancer: a case report
| Autor: | Tomohiro Murakawa, Chika Miyasaka, Haruaki Hino, Hiroshi Matsui, Tomohito Saito, Kahori Nakahama, Natsumi Maru, Takahiro Utsumi, Kayoko Kibata, Koji Tsuta, Makoto Ogata, Yohei Taniguchi |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
RD1-811 Proton beam therapy medicine.medical_treatment Fistula Case Report 030204 cardiovascular system & hematology Broncho-pulmonary artery fistula 03 medical and health sciences Massive hemoptysis 0302 clinical medicine medicine.artery medicine Salvage surgery Lung cancer Bronchus business.industry Cancer Left pulmonary artery medicine.disease Surgery Radiation therapy medicine.anatomical_structure 030220 oncology & carcinogenesis Pulmonary artery business Chemoradiotherapy |
| Zdroj: | Surgical Case Reports Surgical Case Reports, Vol 7, Iss 1, Pp 1-5 (2021) |
| ISSN: | 2198-7793 |
| Popis: | Background Salvage surgery is an effective therapeutic option for patients experiencing relapses after chemoradiotherapy for advanced-stage lung cancer or after high-dose radiotherapy for early-stage lung cancer. We report a case involving an emergent salvage surgery for a patient with massive hemoptysis who developed lung cancer recurrence after undergoing proton beam therapy 7 years prior to presentation. Case presentation A 70-year-old male patient was emergently admitted due to massive hemoptysis. He had undergone proton beam therapy for a stage I adenocarcinoma of the left upper lobe 7 years ago, and was receiving chemotherapy for local recurrence. We performed an emergent salvage pulmonary resection to achieve hemostasis. During the operation, we confirmed the presence of a left broncho-pulmonary arterial fistula, which was considered as the origin of the massive hemoptysis. We repaired the fistula between the pulmonary artery and left upper bronchus without incident; an orifice of the fistula at the left pulmonary artery was sutured using a non-absorbable monofilament, and the central portion of the orifice of the fistula at the left upper bronchus was closed with a mechanical stapling device. The postoperative diagnosis was of an adenocarcinoma—ypT3(pm1) N0M1a (dissemination)-IVA, ef1b. The patient has survived for over a year with the cancer in almost complete remission following the administration of an epidermal growth factor receptor tyrosine kinase inhibitor. Conclusions Emergent salvage surgery demands high skill levels with optimal timing and correct patient selection. Our case suggested that the procedure played an important role in controlling serious bleeding and/or infectious conditions. Consequently, he could receive chemotherapy again and survive for over a year. |
| Databáze: | OpenAIRE |
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