Delayed post-lobectomy pulmonary artery stump thrombosis.

Area of Science:

• Cardiovascular Surgery
• Thoracic Oncology
• Pulmonary Medicine

Background:

• A 67-year-old male with atypical Ewing Sarcoma underwent extensive surgical resection, including VATS right upper lobectomy, en bloc chest wall resection, and right lower lobe superior segmentectomy.
• Post-operative surveillance is crucial for detecting complications after complex thoracic procedures.

Observation:

• Over two years post-resection, serial chest CT scans revealed a new intraluminal filling defect in the right upper pulmonary artery stump.
• This finding raised concerns for potential pulmonary embolism or other vascular complications in the post-operative setting.

Findings:

• A three-month course of oral anticoagulation was initiated for the observed pulmonary artery filling defect.
• Repeat imaging demonstrated complete resolution of the filling defect, suggesting a thrombotic etiology.

Implications:

• This case highlights the potential for late-onset venous thromboembolism in the pulmonary artery stump after major thoracic surgery.
• Prompt diagnosis and anticoagulation therapy can effectively manage such post-operative vascular complications.
• Further research may elucidate the specific risk factors and optimal management strategies for pulmonary artery stump thrombosis.