Pulmonary Resection for Metachronous Lung Cancer Following Contralateral Pneumonectomy

Thomas Tsitsias,Nicholas Harvey,Kelvin W Lau,Prity Gupta,Sridhar Rathinam

doi:10.4236/ojts.2013.31004

Thomas Tsitsias, Nicholas Harvey + Show 3 more

Open Access

https://doi.org/10.4236/ojts.2013.31004

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Abstract

Patients who undergo pneumonectomy for lung cancer are at risk of recurrent disease and metachronous tumours in the remaining lung. Establishing a diagnosis can be difficult as biopsy may induce a pneumothorax, whilst resection is limited by remaining lung function. However, pneumonectomy should not be a contraindication to further lung resection. We report two cases of lung cancer resection in the residual lung 6 and 11 years following pneumonectomy respectively. A limited resection can be safely performed for a new pulmonary parenchymal lesion on a background of a previous pneumonectomy.

Highlights

Patients treated with pulmonary resection for bronchogenic carcinoma still carry the risk of second primary tumour arising from the remaining parenchyma that ranges from 2% to 5% every year [1,2]
We report two separate cases managed in our Department with curative thoracoscopic pulmonary resections 11 and 6 years after contralateral pneumonectomy, respectively
The risk of a new lung cancer or metastatic disease following pneumonectomy is well recognized and every clinician involved on the management of such patients should be alert on their follow-up surveillance

Summary

Introduction

Patients treated with pulmonary resection for bronchogenic carcinoma still carry the risk of second primary tumour arising from the remaining parenchyma that ranges from 2% to 5% every year [1,2]. A few decades ago many physicians thought of lung resection on a single remaining lung as an absolute contraindication. The report though of limited case series [3,4] with encouraging results have started to change the clinicians approach to this complicated condition. There is still a considerable number of patients with adequate functional reserve and no distal metastases that have never been referred, nor even considered for resection being deprived in that way of a potentially lifesaving therapeutic option. We report two separate cases managed in our Department with curative thoracoscopic pulmonary resections 11 and 6 years after contralateral pneumonectomy, respectively

Case 1

Case 2

Findings

Discussion