A case of intractable pneumothorax caused by carcinomatous pleuritis

Abstract

A 92-year-old woman consulted a doctor for dyspnea on effort. Based on the findings of chest-computed radiography, she was diagnosed with a left pneumothorax. We started continuous chest drainage, but air leakage did not resolve, so we planned an operation. When a CT scan was carried out, a nodule was detected in the left upper lobe. Because there were no findings of other lesions caused by pneumothorax, video-assisted thoracic surgery (VATS) was performed, and wedge resection of the tumor was carried out. The tumor was diagnosed as primary lung cancer, and carcinomatous pleuritis was recognized in operative findings. After the operation, the air leakage disappeared, but then relapsed on post-operative day 2. Finally, adhesion therapy was performed. Primary lung cancer complicated with a pneumothorax is rare, and carcinomatous pleuritis may have caused this intractable pneumothorax.