Thoracic Empyema Due to Perforation of Lung Cancer

Abstract

Background: Thoracic empyema due to perforation by lung cancer is rare.
Case: A 73-year-old man with thoracic empyema was admitted to our hospital. Chest X-ray film, CT and thoracoscopy revealed fibropurulent phase empyema and the patient received thoracic drainage, pleural irrigation and drip infusion of antibiotics. Chest CT after thoracic drainage showed a lesion of the right middle lobe, which was supposed to be the cause of thoracic empyema, i.e. pulmonary abscess, lung cancer and so on. Eight days after admission, operation was performed. Thoracotomy revealed empyema due to perforation by lung cancer, and lobectomy of the right middle lobe with decortication was performed. The postoperative course was uneventful and the patient was discharged on the 28th postoperative day.
Conclusion: We conclude that cleaning of the thoracic space by pleural drainage and irrigation enables one-stage radi-cal operation of fibropurulent phase thoracic empyema deriving from lung cancer itself.