A Complication of Thoracic Surgery: A Late-onset Chylomediastinum Resulting from a Left Upper Lobectomy and Lymph Node Dissection through a Median Sternotomy

Abstract

A 63-year-old male with lung cancer underwent a left upper lobectomy and mediastinal lymph node dissection through a median sternotomy. Postoperatively, he received 4 cycles of adjuvant chemotherapy with cisplatin and gemcitabin. Chest computed-tomography (CT) scan after the adjuvant chemotherapy showed a large cystic mass originating from the tracheal bifurcation. Fiberoptic bronchoscopy (FOB) revealed chylomediastinum during the aspiration biopsy of the mass. The chylous effusion was first removed by aspiration under FOB, though 2 weeks later the patient returned with a fever, and the CT lead us to suspect mediastinitis. After performing primary surgery for the removal of chylomediastinum, there was no recurrence thus we concluded that it was the better method.