Endoscopic argon plasma coagulation for the management of solid, centrally located lung cancer

Abstract

Argon plasma coagulation (APC) is one of the interventional pulmonology techniques primarily aimed at the treatment of hemoptysis. It represents a form of non contact electrosurgey that uses ionized argon gas in order to produce electrical current that affects soft tissues. APC is reported to be effective in the treatment of early stage lung cancer, in the treatment of benign granulation tissue surrounding tracheal stents and in palliative treatment of malignant airway obstruction. Major indication for APC is hemostasis in severe hemoptysis, it can also be used as an alternative technique for laser resection or electrocautery, in urgent removal of tumors situated in large airways. The present article reports successful use of APC in the treatment of centrally located squamous cell lung cancer that caused complete right lung atelectasis. The use of APC led to complete reexpansion of the right lung and improvement in dyspnoea and chest discomfort of the patient. Significant improvement was observed in lung function parameters and blood gas analysis. With the use of APC solid tumor was completely removed from the right main bronchus and airway integrity was restored. From this case we can conclude that APC can be safely and successfully used for urgent debulking of malignant central airway obstruction.