Abstract
A 71-year-old man was scheduled to receive chemotherapy for malignant lymphoma. Because he developed mycosis of the left lung, prior to chemotherapy, left upper lobectomy was performed via a posterolateral thoracotomy. Due to severe adhesion, the fourth rib was detached on the dorsal side, and the fifth rib was resected. Because the scapula covered the thoracic wall defect sufficiently, no reconstruction was performed. However, the patient's respiration was unstable after surgery, and artificial ventilation was required for two days. Once sedation wore off, the patient experienced left shoulder pain. CT showed that the left scapula had invaginated into the pleural cavity through the thoracic wall defect. The scapula was reduced under general anesthesia, and the thoracic wall was reconstructed. The postoperative course was favorable. Although invagination of the scapula into the pleural cavity is a rare complication, we must keep it in mind when postoperative artificial ventilation is required.
