Mucoepidermoid carcinoma in chronic empyema, successful treatment with a pedicled omental flap; a case report.

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A mucoepidermoid carcinoma in a chronic empyema pocket was resected, and reconstruction was achieved with a pedicled omentum and latissimus dorsi muscle flap.<BR>A 76-year-old woman who had had an abnormal chest X-ray shadow 30 years earlier was admitted to our Department of Surgery with symptoms of dyspnea and edema of the lower extremities. The chest X-ray and CT scan revealed a huge right chronic pyothorax. Following intrathoracic tube drainage, partial resection of the cavity wall and curettage were performed through a right thoracotomy. Reexpansion of the right lung was inadequate, and a large cavity persisted. The thoracic cavity was successfully filled by a pedicled omentum fixed with a latissimus dorsi muscle flap. During the operation we found a polypoid tumor 15 mm in diameter in the thick empyema wall. Histological examination showed it to be a mucoepidermold carcinoma. She died well for 4 months following the operation, but then had a sudden episode of acute heart failure. Resucitative measures were unsuccessful.<BR>We should pay attention to the possible existence of a malignant tumor in chronic empyema. The use of an omental flap for serious infection and dysfunction of the lung are a reasonable maneuver because of their excellent blood and lymphatic supply.
特定非営利活動法人日本呼吸器外科学会の論文