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Updated: Jul 8, 2026

Thoracoscopic Extended Right Middle Plus Lower Sleeve Lobectomy for Non-Small-Cell Lung Cancer
Published on: February 27, 2026
[Bronchiolo-alveolar cell carcinoma of the lung presenting as spontaneous pneumothorax]
1Division of Internal Medicine, Kure Kyosai Hospital, 2-3-28 Nishichuou Kure, Hiroshima, Japan.
Abstract:
A 30-year old man visited a local clinic complaining of dyspnea and chest pain. He had a history of hepatocystadenocarcinoma 10 years before. Pneumothorax was diagnosed. Immediately, the patient was referred to us and underwent a tube thoracostomy. Cytologic examination of pleural effusion specimens revealed malignant cells. Because pleural drainage and pleurodesis using anti-cancer agents were not effective, we performed a thoracotomy. A tumor with accompanying bulla was detected in the right S6 region and a right lower lobectomy was performed. Histologic examination of tumor specimens disclosed bronchiolo-alveolar cell carcinoma. We speculated that bullae formed by tumor invasion, had burst, resulting in pneumothorax. This was a case of asynchronous double cancer in a relatively young patient, and the first report in Japan of bronchiolo-alveolar cell carcinoma presenting with spontaneous pneumothorax as an initial symptom.
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