Cavitary lung cancer presenting as subcutaneous emphysema on the contralateral side

Abstract

Bronchocutaneous fistula is an extremely rare complication of lung cancer and is frequently seen following biopsy or radiotherapy. A 67-year old male patient was administered to our hospital due to sudden onset of shortness of breath and subcutaneous emphysema on the right side. Chest computed tomography revealed a cavitary lesion in the left upper lobe in connection with the subcutaneous emphysema on the right side through sternum and anterior chest wall. The pathological examination of the biopsy performed during tube insertion revealed a well-differentiated squamous cell carcinoma of the lung. The patient was referred for adjuvant therapy to local oncology hospital. He passed away 9 months following diagnosis.

Figure 1:

Chest X-ray of the patient in the emergency room showing diffuse subcutaneous emphysema on the right hemithorax and neck, and a cavitary lesion in upper left zone.

Figure 2:

Chest CT scan of the patient showing the cavitary lesion in the left upper lobe, the air tract crossing over to the right side causing diffuse subcutaneous emphysema.