The Journal of the Japanese Association for Chest Surgery
Online ISSN : 1881-4158
Print ISSN : 0919-0945
ISSN-L : 0919-0945
Chest wall implantation of lung cancer associated with CT-guided needle biopsy: Report of a case
Yoshitaka FujiiTatsuya NishidaIwao MikamiKenichi Wakasa
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JOURNAL FREE ACCESS

2017 Volume 31 Issue 5 Pages 653-657

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Abstract

The intrathoracic seeding and chest wall implantation of lung cancer by CT-guided needle biopsy is rare, but when it does occur, it is a serious complication that adversely affects the prognosis. A 66-year-old male underwent CT-guided needle biopsy for a nodule in the left lung S3a region that was later diagnosed to be lung cancer. We performed left upper lobectomy with lymph node dissection by video-assisted thoracoscopic surgery. The postoperative histopathological diagnosis was adenosquamous carcinoma, pStage IB. At four months after surgery, chest CT revealed the presence of another tumor measuring 10 cm in diameter in the left pectoralis major and minor muscles. We performed percutaneous needle biopsy for this tumor, and its cytology was class V, but its histologic type could not be determined. For both a definitive diagnosis and treatment, we performed left chest wall tumor excision including second and third rib resection and chest wall reconstruction. The pathological diagnosis was adenosquamous carcinoma, and we diagnosed the occurrence of chest wall implantation by the biopsy needle due to the fact that the position of the chest wall tumor and biopsy needle track were consistent based on chest CT findings, and there had been no recurrence of lung cancer for one year and seven months after surgery. Needle track implantation by CT-guided needle biopsy is rare, but it is a significant complication that should be avoided as much as possible. As a result, when performing CT-guided needle biopsy, extreme care should be taken to avoid such an occurrence.

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© 2017 The Japanese Association for Chest Surgery
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