Use of the Thoracic Egg^® to Treat Intractable Pneumothorax in a Five-year-old Boy with Metastatic Angiosarcoma of the Lung

Abstract

A five-year-old boy was examined at a local clinic for coughing and malaise. Chest X-ray showed bilateral pleural effusions, left pneumothorax, and a pericardial effusion, and he was referred to our hospital. Computed tomography showed multiple nodular shadows in the bilateral lung fields and a mass in the right atrium. Following bilateral thoracic cavity and pericardial drainage, a lung tissue biopsy was performed, and angiosarcoma was diagnosed. The presence of multiple lung metastases made the survival prognosis extremely poor. Because air leakage from the left thoracic cavity persisted after chemotherapy had been started, the chest drain was replaced by a Thoracic Egg^® (TE), a simple pneumothorax drainage kit, to enable the boy to be taken home. Although the air leakage subsequently continued, lung collapse did not progress, and he was discharged 14 days after the switch to the TE. The underlying condition deteriorated, and he died about 5 months after diagnosis, having mainly been cared for at home. Although a few cases of the use of the TE for outpatient pneumothorax treatment have been reported in recent years, this is the first report of its use in a young child. Although this is an extremely rare case, the value of the TE as a therapeutic option for intractable pneumothorax is reported.