A case of poorly differentiated squamous cell carcinoma discovered in bullae resected from a secondary pneumothorax in a young patient with severe emphysema

Araki Kota, Hayashi Naohiro, Washio Kazuhiro

doi:10.2995/jacsurg.37.15

<p>Emphysema usually progresses with prolonged exposure to tobacco smoke, which is rare in young patients. Lung cancer often occurs in patients with emphysema, which also rarely occurs in young patients. We report a case of lung cancer discovered in a pneumothorax bullectomy specimen from a young patient with severe emphysema. The patient was a 34-year-old man who had smoked 20 cigarettes/day for 4 years from the age of 14 to 17 and for 15 years from the age of 20 to 34. He had worked as a shipbuilding painter, and his older brother had a history of pneumothorax. He developed a pneumothorax (secondary to severe emphysema) for which a bullectomy was performed. Two nodules were detected in the widely resected bullae, one of which was diagnosed as poorly differentiated squamous cell carcinoma. Lung cancer may occasionally be seen in patients with pneumothorax, but most cases have been reported in elderly patients (and rarely in young patients). However, severe emphysema is common in people with a history of marked exposure to tobacco smoke, which is also known to increase the risk of lung cancer. Therefore, caution should be taken to rule out lung cancer when managing pneumothorax in young patients with severe emphysema, as seen in this case.</p>

A case of poorly differentiated squamous cell carcinoma discovered in bullae resected from a secondary pneumothorax in a young patient with severe emphysema

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