Surgical treatment of lung cancer with extended left pneumonectomy and partial resection of thoracic aorta in the patient with massive hemoptysis – Case report

Abstract

Severe airway bleeding or massive hemoptysis is a rare condition that carries high mortality. Patients are at risk of life-thretening respiratory compromise due to the airways filling with blood. The main principles in the management of massive hemoptysis are: maintainance of airway patency, localization of the source of bleeding and control of the hemorrhage. Most cases of massive hemoptysis are caused by inflammatory lung diseases such as aspergiloma, tuberculosis and bronchiectasis while a severe bleeding from a malignant lung tumor is a rare find.We present a case of massive hemoptysis in a 60-year old woman, caused by the invasion of lung cancer into the left pulmonary trunk and aorta, which was successfully managed by an extended left pneumonectomy, with the resection of the proximal part of the descending thoracic aorta and interposition of a vascualar graft without extra corporeal circulation. A complete (R0) resection was also achieved.

Keywords

• airway bleeding, respiratory failure, bronchoscopy, CT angiography, operative treatment