Abstract
A 69-year-old man was referred to our department in February, 1993, because of a nodular lesion (2 cm in diameter) in his left lower lung field noted on chest X-ray and suspected of being a metastasis of rectal cancer which had been removed in June, 1990. His right thorax was deformed by thoracoplasties performed for tuberculosis, in 1956 and 1958. Partial lung resection with VATS of S9 completely removed the tumor and spared the chest muscles. Pathological examination of the removed lung (4.5×2.5×2.5 cm) and the tumor revealed metastatic rectal cancer. The postoperative course was uneventful.
In August, 1994, however, chest X-ray and chest CT showed a peanut-sized mass in S9, which was suspected of being a recurrent metastatic tumor. Partial lung resection with VATS of S9, including the tumor, was performed through a muscle sparing thoracotomy. Pathological examination of the tumor again revealed rectal cancer metastasis. The postoperative course was uneventful. His lung function was only slightly reduced in spite of two lung resections with VATS. Two and a half years have passed since the first VATS for lung metastasis, and his performance status (PS) and quality of life (QOL) have not changed despite two operations. This case shows stepped lung resection is an effective strategy for metastatic lung tumor in patients with impaired lung function.
