Surgical resection of lung cancer in a patient with von Willebrand's disease

Abstract

A 52-year-old man, who was going to undergo an operation for squamous cell carcinoma of the lung, was found to have a history of frequent spontaneous epistaxis and a family history of von Willebrand's disease in his nephews. Laboratory data showed a normal platelet count, normal prothrombin time, and normal activated partial thromboplastin time. Further examination, however, revealed a prolonged bleeding time (5 minutes, 30 seconds) and a decrease in von Willebrand factor (<6%) and factor VIII (65.3%), and a diagnosis of von Willebrand disease was established. After confirming an improvement of the bleeding time to 2 minutes with the intravenous administration of factor VIII/von Willebrand factor compound (Confact F), pulmonary resection was successfully carried out. With the daily administration of Confact F during the perioperative period, the postoperative course was uneventful and no clinical bleeding occurred.