Video-Assisted Thoracic Surgery (VATS) Lobectomy for a Double Lung Cancer in a Patient With Systemic Sclerosis.

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Background: Collagen disease often induces lung fibrosis, which sometimes results in primary lung cancer, and it is difficult to perform curative resection safely in such cases, because the patient's respiratory function is usually very poor. Case: A 71-year-old man was admitted for further examination of an abnormal shadow on a chest X ray in April 1999. He had been receiving oral medication, other than steroids, for dyspnea due to lung fibrosis for the previous 4 years. Serological examination showed positive result for the anti Scl-70 antibody, which is specific to systemic scleroderma. Bronchoscopic examination revealed a poorly differentiated adenocarcinoma in right S8. Video assisted left lower lobectomy and mediastinal lymphadenectomy was performed to minimize the invasiveness of the operation minimally. Histological examination revealed lung fibrosis and poorly differentiated squamous cell carcinoma in both S8 and S10, both of which were considered to be primary lesions. No major complications were observed during the patient's hospital stay and he is well and disease-free six months after the operation. Conclusion: VATS lobectomy was useful in performing complete resection for lung cancer in a case of pulmonary fibrosis with anti Scl-70 antibody.
特定非営利活動法人日本肺癌学会の論文