Top

BMC Surgery

Published in:

Open Access 01-12-2018 | Case report

Successful pulmonary arterial embolization followed by curative surgery for a lepidic predominant lung adenocarcinoma with severe hypoxemia

Authors: Louise Sebane, Mostafa El-Hajjam, Philippe Puyo, Elisabeth Longchampt, Etienne Giroux Leprieur

Published in: BMC Surgery | Issue 1/2018

Abstract

Background

Lepidic predominant adenocarcinoma is characterized by frequent refractory hypoxemia due to intrapulmonary shunting. Severe hypoxemia can induce perioperative complications in case of thoracic surgery.

Case presentation

We 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.

Conclusions

This is the first case-report of successful endovascular embolization before curative surgery for a lepidic predominant lung adenocarcinoma.

Travis WD, Brambilla E, Noguchi M, et al. International association for the study of lung cancer/american thoracic society/european respiratory society international multidisciplinary classification of lung adenocarcinoma. J Thorac Oncol. 2011;6:244–85.CrossRefPubMedPubMedCentral

Wolinsky H, Lin A, Williams MH Jr. Lung perfusion in bronchiolo-alveolar carcinoma. A case report. Am Rev Respir Dis. 1969;99:585–9.PubMed

Barlesi F, Doddoli C, Thomas P, Kleisbauer JP, Giudicelli R, Fuentes P. Bilateral bronchioloalveolar lung carcinoma: is there a place for palliative pneumonectomy? Eur J Cardiothorac Surg. 2001;20(6):1113–6.CrossRefPubMed

Chetty KG, Dick C, McGovern J, Conroy RM, Mahutte CK. Refractory hypoxemia due to intrapulmonary shunting associated with bronchioloalveolar carcinoma. Chest. 1997;111(4):1120–1.CrossRefPubMed

Falcoz PE, Hoan NT, Le Pimpec-Barthes F, Riquet M. Severe hypoxemia due to intrapulmonary shunting requiring surgery for bronchioloalveolar carcinoma. Ann Thorac Surg. 2009;88(1):287–8.CrossRefPubMed

Fishman HC, Danon J, Koopot N, Langston HT, Sharp JT. Massive intra- pulmonary venoarterial shunting in alveolar cell carcinoma. A case report. Am Rev Respir Dis. 1974;109(1):124–8.PubMed

Sarlin RF, Schillaci RF, Georges TN, Wilcox JR. Focal increased lung perfusion and intrapulmonary veno-arterial shunting in bronchiolo-alveolar cell carcinoma. Am J Med. 1980;68(4):618–23.CrossRefPubMed

Wartski M, Zerbib E, Regnard JF, Herve P. Reverse ventilation-perfusion mismatch in lung Cancer suggests intrapulmonary functional shunting. J Nucl Med. 1998;39:1986–9.PubMed

Tan JYA, Walters DL, Poon K, Zimmerman P, Aldons P. Palliative embolisation for intrapulmonary shunting in lepidic predominant adenocarcinoma of the lung. Respir Med Case Rep. 2015;15:121–4.PubMedPubMedCentral

10.

Crossno PF, Milstone AP, Lambright ES, Carbone DP, Light RW. Severe intrapulmonary shunting in bronchioloalveolar cell carcinoma corrected by selective pulmonary artery occlusion and palliative tumor resection. Chest. 2006;130(4Meetingabstracts):313S-c-314S.

11.

Brunelli A, Kim AW, Berger KI, Addrizzo-Harris DJ. Physiologic evaluation of the patient with lung cancer being considered for resectional surgery: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013;143(5 Suppl):e166S–90S.CrossRefPubMed

12.

Celli BR. What is the value of preoperative pulmonary function testing? Med Clin North Am. 1993;77(2):309–25.CrossRefPubMed

13.

Zibrak JD, O’Donnell CR, Marton K. Indications for pulmonary function testing. Ann Intern Med. 1990;112(10):763–71.CrossRefPubMed

Title: Successful pulmonary arterial embolization followed by curative surgery for a lepidic predominant lung adenocarcinoma with severe hypoxemia
Authors: Louise Sebane
Mostafa El-Hajjam
Philippe Puyo
Elisabeth Longchampt
Etienne Giroux Leprieur
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Surgery / Issue 1/2018
Electronic ISSN: 1471-2482
DOI: https://doi.org/10.1186/s12893-018-0351-1

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Successful pulmonary arterial embolization followed by curative surgery for a lepidic predominant lung adenocarcinoma with severe hypoxemia

Abstract

Background

Case presentation

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Case presentation

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2018

Successful joint preservation of distal radius osteosarcoma by en bloc tumor excision and reconstruction using a tumor bearing frozen autograft: a case report

Treatment of deep cavities using a perforator-based island flap with partial de-epithelization

Synovial cysts of the hip joint: a single-center experience

Learning curve of laparoscopic Kasai portoenterostomy for biliary atresia: report of 100 cases

Spontaneous omental bleeding: a case report and literature review

A dissonance-based intervention for women post roux-en-Y gastric bypass surgery aiming at improving quality of life and physical activity 24 months after surgery: study protocol for a randomized controlled trial