Abstract
BackgroundLepidic predominant adenocarcinoma is characterized by frequent refractory hypoxemia due to intrapulmonary shunting. Severe hypoxemia can induce perioperative complications in case of thoracic surgery.Case presentationWe report a case of a 67 year-old woman with localized lepidic adenocarcinoma in the right lower lobe with severe hypoxemia. A selective arterial lung embolization allowed an instantaneous correction of the hypoxemia, and a curative lobectomy was safely performed 1 week after without any complication. The staging was pT3N0M0, and the patient received adjuvant chemotherapy.ConclusionsThis is the first case-report of successful endovascular embolization before curative surgery for a lepidic predominant lung adenocarcinoma.
Highlights
Lepidic predominant adenocarcinoma is characterized by frequent refractory hypoxemia due to intrapulmonary shunting
We present here the case of a 67 year-old women with localized lepidic predominant adenocarcinoma and severe hypoxemia due to intrapulmonary shunting, who was successfully treated by pulmonary arterio-embolization followed by curative lower lobe resection
The deep hypoxemia observed occasionally in lepidic lung adenocarcinoma is due to the filling of alveolar spaces by tumor cells, along with normal perfusion of these territories
Summary
Lepidic predominant adenocarcinoma is characterized by frequent refractory hypoxemia due to intrapulmonary shunting. Background Adenocarcinoma is the most frequent histological subtype in non-small cell lung cancer (NSCLC). Lepidic predominant subtype is a particular form of invasive lung adenocarcinoma, developed initially from Club cells and/or type II pneumocytes [1].
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