"Drowned lung" following lobectomy and radiation therapy: a case report

Radiation therapy for locoregional control of NSCLC is controversial, and risk factors for developing radiation associated pneumopathies must be assessed before any patient undergoes adjuvant radiation therapy. Radiotherapy for patients with early stage NSCLC may be associated with increased morbidity and decreased survival. As evidenced by our case, adjuvant radiation therapy for a patient with significant risk factors and early stage disease generated morbidity from the treatment itself. It contributed to development of a bronchopleural fistula and chronic empyema, and led to distortion and obstructing of the airway causing irreversible pulmonary consolidation ("drowned lung"). Further, the final pathology report showed clear margins, suggesting that there was no clear indication for radiation therapy. Although NSCLC, the potential risks cannot be overlooked and patients should be carefully evaluated before recommending postoperative therapy.