Case report: A case of acute respiratory failure caused by ventilation-perfusion mismatch due to hilar lung cancer

Abstract

Case. A 67-year-old man with a right lung tumor was referred to our hospital. The clinical diagnosis was lung cancer cT3N2M0 stage IIIA with interruption of the right main pulmonary artery and obstruction of the right main bronchus. He had no symptoms on admission, but he complained of dyspnea the next day. Computed tomography on searching for the cause of hypoxia showed enlargement of the right pulmonary artery and the absence of pneumothorax, pneumonitis, atelectasis, and carcinomatous lymphangiosis. The hypoxia was reversed in a left lateral position. We considered that the cause of the respiratory failure was ventilation-perfusion mismatch by recanalization of the pulmonary artery. Right carinal pneumonectomy was performed, and the patient was discharged without oxygen eight days after surgery. Conclusion. We reported a case of ventilation-perfusion mismatch due to hilar lung cancer. In the management of acute respiratory failure in patients with central lung cancer, the probability of improvable hypoxia such as ventilation-perfusion mismatch should be considered.