Resolution of an equivocal lesion that developed at the bronchial stump after lung cancer surgery by administration of tranilast

Abstract

Space-occupying lesions that develop around the bronchial stump after lung cancer surgery are sometimes difficult to distinguish from postoperative recurrence. Herein, we report a patient who developed a progressively growing tumorous lesion at the bronchial stump after lung cancer surgery. The lesion was reduced in size with the administration of tranilast and not regarded as postoperative recurrence. The patient was a 75-year-old woman. She underwent thoracoscopic right lung segmentectomy for right upper lobe lung adenocarcinoma (pT1aN0M0). Computed tomography (CT) performed at 38 months after surgery showed an invasive shadow around the resection stump. Bronchoscopic biopsy was performed, but no diagnosis was made. Tranilast was administered for a suspected foreign-body granuloma at the resection stump for three months until it was discontinued due to liver damage, and the shadow diminished. CT conducted at 70 months after surgery showed that the tumor-like shadow had enlarged again and tranilast was re-administered in combination with a hepatoprotective drug. The lesion was reduced again and remains shrunk. We suggest that tranilast may be effective for differential diagnosis when a lesion around the resection margin of lung cancer is suspected of being a granuloma.