A case of primary lung cancer incidentally detected from a histological specimen following surgery for spontaneous pneumothorax in a young male patient

Abstract

An 18-year-old man was referred to our hospital after visiting a doctor's office for left-sided chest discomfort. In our hospital, he was diagnosed with spontaneous left pneumothorax, and admitted for treatment. Thereafter, he underwent video-assisted thoracoscopic (VATS) bullectomy. A 2-mm-diameter tumor was detected on the staple line, and a specimen was harvested for histopathological examination. He was diagnosed with left spontaneous pneumothorax with primary lung adenocarcinoma (pT1a). Because the surgical margin was positive, we performed an additional VATS partial resection 1 month after the initial diagnosis. The new specimen did not show signs of residual adenocarcinoma, and the patient has been disease-free for 26 months. It is important to analyze computed tomography scans of the chest carefully because tiny pulmonary nodules may be found adjacent to a predicted surgical margin even in young patients presenting with a benign condition, such as pneumothorax.