Case Report-A Rare Congenital Lung Defect

Case Report

Austin J Clin Case Rep. 2023; 10(4): 1289.

Case Report-A Rare Congenital Lung Defect

Christos Simoglou¹*; Igner Bertus²

1Department of Thoracic Surgery, Red Cross General Hospital, Athens, Greece

2Department of Cardiothoracic Surgery Universital Hospital of Bristol, UK

*Corresponding author: Christos Simoglou Department of Thoracic Surgery, Red Cross General Hospital, Athens, Greece. Email: simoglouchristosdoctor@yahoo.com

Received: May 20, 2023 Accepted: June 12, 2023 Published: June 19, 2023

Abstract

A 72 year old male smoker presented with haemoptysis and recurrent pneumonias. Chest CT showed an emphysematous cyst and air-fluid level cavities in the left lower lobe, (Figure 1). A left lower lobectomy was performed. Intraoperative finding was an intralobar sequestration. Histopathology revealed the presence of adenocarcinoma within the sequestrated lobe.

Keywords: Complication; Pulmonary infection; Thoracoscopic procedures

Introduction

Pulmonary sequestration is a rare congenital lung defect in which nonfunctioning lung tissue is separated from the normal tracheobronchial tree and receives vascular blood supply from an aberrant systemic artery.

While it is not in itself a life-threatening condition, a pulmonary sequestration can cause health complications including cardiovascular problems, long-term infections like tuberculosis and bronchial cancer. It could be fatal if blood vessels in the begin to hemorrhage.

Case Report

We report a case of a 72 year old male patient, smoker (40 pack years), with history of haemoptysis and recurrent pneumonias. CT of the thorax showed an emphysematous cyst and multiple air-fluid level cavities in the left lower lobe, (Figure 1). A left lower lobectomy was decided due to the patient’s history and extent of damage of the lobe. The intraoperative finding was an intralobar sequestration with an aberrant artery arising from the descending thoracic aorta. The histopathological examination revealed a tumor with a size of 2.7cm within the sequestrated lung tissue, which was found to be adenocarcinoma. As the tumor was not diagnosed in the preoperative CT scan, a work-up was done post-operatively. The abdominal CT showed a lymph node of 5,1cm in size around the left renal artery. The tumor was staged as stage IV (pT1N0M1) and the patient received adjuvant chemotherapy. After three cycles of chemotherapy, the size of the lymph node decreased only to 3.7cm. The radiology scan also revealed infiltration of the left hemithorax and metastasis to the thoracic spine. The patient was sent for radiotherapy treatment, during which a rapid deterioration of his clinical condition occurred and finally he succumbed to his ailment 27 months after the thoracic procedure.

Citation: Simoglou C, Bertus I. Case Report-A Rare Congenital Lung Defect. Austin J Clin Case Rep. 2023; 10(4): 1289.