Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2013 Feb 1:6:38.
doi: 10.1186/1756-0500-6-38.

Surgery for lung adenocarcinoma with smokers' polycythemia: a case report

Yasoo Sugiura  1 , Etsuo Nemoto, Hiromi Shinoda, Naoya Nakamura, Shizuka Kaseda
Affiliations
Case Reports

Surgery for lung adenocarcinoma with smokers' polycythemia: a case report

Yasoo Sugiura et al. BMC Res Notes. .

Abstract

Background: Smoking is a cause of cancer and polycythemia. Therefore, surgeons who treat patients with cancer may also encounter patients with polycythemia. However, few cases of surgical patients with polycythemia have been reported; in particular, a surgical case involving smokers' polycythemia has never been reported. We herein report a patient with lung cancer and smokers' polycythemia who successfully underwent lobectomy with control of hematocrit based on a modified formula in the perioperative period.

Case presentation: A 67-year-old man underwent abdominoperineal resection for rectal carcinoma in June 2008. A ground glass opacity had been identified in the upper lobe of the right lung and was gradually enlarging. In March 2012, bronchoscopic cytology for investigation of the mass revealed non-small cell lung cancer, suggesting primary lung non-small cell carcinoma (T1bN0M0, Stage IA). When he was referred to our hospital for surgery, his complete blood count showed a red blood cell level of 6.50×106/μL, hemoglobin of 21.0 g/dL, and hematocrit of 60.1%. The hematologists' diagnosis was secondary polycythemia due to heavy smoking (smokers' polycythemia) because the white blood cell and platelet counts were within normal limits and the erythropoietin was not increased. We calculated the appropriate phlebotomy and infusion volumes based on a formula that we modified. After 550 g of blood was phlebotomized to reduce the hematocrit to approximately 55%, video-assisted right lung upper lobectomy with lymph node dissection was performed in April 2012. The hematocrit was maintained at <50% postoperatively, and the patient was uneventfully discharged on postoperative day 7. The predictive hematocrit and measured hematocrit were very closely approximated in this case.

Conclusion: We experienced a patient with smokers' polycythemia who underwent right upper lobectomy for adenocarcinoma. The findings in this case report are meaningful for surgeons treating cancer patients because there are few reports discussing the perioperative care of surgical patients with polycythemia.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Chest computed tomography and X-ray photography. (A) Computed tomography, June 2009. (B) Computed tomography, January 2011. (C) Computed tomography, March 2012. (D) Chest X-ray photography, March 2012. The GGO at the lateral aspect of right S1 was enlarging, and it became a mass. GGO: ground glass opacity.
Figure 2
Figure 2
Formula for predictive HCT after phlebotomy. HCT: hematocrit, HCT': predictive HCT after phlebotomy, BW: body weight, Wp: weight of phlebotomy, SG: specific gravity, Vi: volume of infusion.
Figure 3
Figure 3
Predictive HCT and phlebotomy in the perioperative period. HCT: hematocrit.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Steliga MA, Dresler CM. Epidemiology of lung cancer: smoking, secondhand smoke, and genetics. Surg Oncol Clin N Am. 2011;20:605–618. doi: 10.1016/j.soc.2011.07.003. - DOI - PubMed
    1. Smith JR, Landaw SA. Smokers' polycythemia. N Engl J Med. 1978;298:6–10. doi: 10.1056/NEJM197801052980102. - DOI - PubMed
    1. Marchioli R, Finazzi G, Landolfi R, Kutti J, Gisslinger H, Patrono C, Marilus R, Villegas A, Tognoni G, Barbui T. Vascular and neoplastic risk in a large cohort of patients with polycythemia vera. J Clin Oncol. 2005;23:2224–2232. doi: 10.1200/JCO.2005.07.062. - DOI - PubMed
    1. Pearson TC, Messinezy M. The diagnostic criteria of polycythaemia rubra vera. Leuk Lymphoma. 1996;22(Suppl 1):87–93. - PubMed
    1. McMullin MF, Bareford D, Campbell P, Green AR, Harrison C, Hunt B, Oscier D, Polkey MI, Reilly JT, Rosenthal E, Ryan K, Pearson TC, Wilkins B. General Haematology Task Force of the British Committee for Standards in H. Guidelines for the diagnosis, investigation and management of polycythaemia/erythrocytosis. Br J Haematol. 2005;130:174–195. doi: 10.1111/j.1365-2141.2005.05535.x. - DOI - PubMed

Publication types