2024 Volume 38 Issue 4 Pages 326-332
A 77-year-old man with emphysema underwent thoracoscopic left upper lobectomy for primary lung cancer. Three days after the lobectomy, the subcutaneous emphysema expanded rapidly. Chest computed tomography (CT) revealed a 5.5-cm pneumatocele that developed postoperatively in the superior segment of the left lower lung. Surgery was performed on postoperative day 7 because of persistent air leakage, which revealed a pulmonary laceration with air leakage in the anterior basal segment of the left lower lung, and it was repaired. Surgical treatment was not performed for the pneumatocele because there was no leakage from it. Thereafter, the pneumatocele shrank spontaneously. After starting adjuvant chemotherapy, a chest radiograph showed a 9.5-cm lung cyst at the base of the lower left lung field, and bloody sputum was observed in the same period. Consequently, adjuvant chemotherapy was discontinued, and the bloody sputum improved immediately. A year after the lobectomy, chest CT showed that both pneumatoceles had shrunk spontaneously, and there was no lung cancer recurrence. Postoperative pneumatocele is rare, and the treatment strategy has not been determined. This report suggests that conservative treatment may lead to cure.
