A Case of Synchronous Bilateral Central Type Early Stage Bronchogenic Carcinoma

Successful Combined Treatment of Segmentectomy, YAG Laser Irradiation and Bronchial Arterial Infusion (BAT)

Abstract

A 60 year-old man was admitted to our hospital complaining of bloody sputum. He was a heavy smoker with a Brinkman Index of 1200. Chest roentgenogram was normal, but fiberoptic bronchoscopy revealed two small tumors in bilateral bronchi, one at the orifice of right B⁶, the other at the bifurcation of the left lingular and the upper division bronchi. Several biopsies demonstrated them to be squamous cell carcinoma, and a diagnosis of synchronous bilateral central type early stage bronchogenic carcinoma was made. After YAG laser irradiation and bronchial arterial infusion (BAI) with MMC, right S⁶ segmentectomy and the wedge resection of the lower bronchus were performed. The resected specimen revealed that the tumor was localized within the bronchial wall, with no metastasis. Further therapy was not done, as the left tumor had disappeared completely. For 15 months from the operation to date, no recurrence has been found. We concluded that a combination of YAG laser irradiation and BAI might be one of the effective therapies against central type early stage bronchogenic carcinoma.