A case of pneumonectomy for lung cancer associated with scleroderma
Yoshida, H.; Ono, S.; Sugawara, T.; Endo, C.; Handa, M.; Suda, S.; Kobayashi, S.; Kondo, T.; Fujimura, S.
Kyobu Geka. Japanese Journal of Thoracic Surgery 54(7): 606-609
2001
ISSN/ISBN: 0021-5252 PMID: 11452535 Document Number: 528104
A 60-year-old female, diagnosed as scleroderma, was referred to our hospital because of symptoms of common cold and abnormal findings on a chest X-ray. The chest X-ray and CT scan revealed a mass in the left upper field, suspected to invade left anterior chest wall. Moreover, fibrotic changes were observed in the lung field. Cytology by bronchofiberscopy showed squamous cell carcinoma. Evaluation of pulmonary function, including unilateral pulmonary artery occlusion test (UPAO), revealed possibility of lung resection. Subsequently, pneumonectomy with combined resection of left 1st rib was performed. Postoperative course was uneventful and she was discharged. She was admitted again four months after the operation with appetite loss and body weight loss. Further examinations revealed arrhythmia, renal failure, pancreatitis and liver metastasis. Her general conditions grew worse and she died five months after the operation. In conclusion, UPAO was a useful method to determine the functional lung resectability for the case with scleroderma. However, effects of surgical stress for the development of scleroderma remain to be elucidated.