Late-onset bronchopleural fistula after lobectomy and adjuvant chemotherapy for lung cancer: A case report and review of the literature.

Abstract

RATIONALE:

Late-onset bronchopleural fistula (BPF) induced by chemotherapy after lobectomy for lung cancer is rarely reported, lacking reliable preventive approaches. A timely identification and individualized treatment is essential for prognosis.

PATIENT CONCERNS:

A 52-year-old female patient complained of fever, productive cough, and fatigue 1 week after adjuvant chemotherapy following right lower lobectomy and systemic mediastinal lymph node dissection. Chest computed tomography (CT) indicated pneumothorax and thick-walled empyema cavity within her right-sided thorax.

DIAGNOSES:

The patient was diagnosed as late-onset BPF based on clinical manifestation and chest radiography.

INTERVENTIONS:

In addition to antibiotics, a chest tube was reinserted under CT guidance, and vacuum suction was utilized for continuous drainage. Next cycle of adjuvant chemotherapy was terminated.

OUTCOMES:

The empyema cavity was gradually closed in 1 month after conservative treatment, and the patient survived with good condition up to now.

LESSONS:

Late-onset BPF should be kept in mind when the patient suffered from productive cough and chills during postoperative chemotherapy. And a prompt conservative management might be effective.

• Authors: Chu Zhang, Yong Pan, Rui-Mei Zhang, Wen-Bin Wu, Dong Liu, Miao Zhang
• Journal: Medicine (Medicine (Baltimore)) Vol. 98 Issue 26 Pg. e16228 (Jun 2019) ISSN: 1536-5964 [Electronic] United States
• PMID: 31261579 (Publication Type: Case Reports, Journal Article, Review)

Topics

• Bronchial Fistula (etiology)
• Chemotherapy, Adjuvant (adverse effects)
• Female
• Humans
• Lung Neoplasms (therapy)
• Middle Aged
• Pleural Diseases (etiology)
• Pneumonectomy (adverse effects)
• Postoperative Complications (etiology)
• Time Factors