Abstract
A 73-year-old man, who underwent right upper lobectomy and plombage for pulmonary tuberculosis in 1958, was referred to our hospital with a diagnosis of chronic expanding hematoma after complaining of hemoptysis, right axillary swelling, and dyspnea in 2008. Chest CT showed a huge mass in the chest cavity protruding beyond the axilla and causing marked tracheal deviation to the left. He underwent hematoma evacuation and peeling through a modified Hemi-Clamshell approach after transcatheter arterial embolization of the subclavian artery branches. The postoperative course was uneventful. Dyspnea was resolved and he was discharged on the 20th postoperative day. The modified Hemi-Clamshell approach facilitates a wider opening of the sternocostal flap, with safe control of the entire subclavian vessels.
