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. 2017 Dec;3(1):37.
doi: 10.1186/s40792-017-0313-3. Epub 2017 Feb 22.

Spontaneous torsion of the right upper lung lobe: a case report

Yusuke Kita  1 , Tetsuhiko Go  2 , Kazuhito Nii  2 , Natsumi Matsuura  2 , Hiroyasu Yokomise  2
Affiliations

Spontaneous torsion of the right upper lung lobe: a case report

Yusuke Kita et al. Surg Case Rep. 2017 Dec.

Abstract

Background: Pulmonary torsion is usually caused by thoracic surgery or trauma. Spontaneous pulmonary torsion caused by tumor and pleural effusion is very rare.

Case presentation: A 76-year-old Asian male with a chronic cough and suspected lung or pleural tumor presented with sudden dyspnea. Computed tomography showed that the right upper lung lobe contained a large tumor in the region of S1-3; the tumor had shifted to the posterior thoracic space and rotated 90° counterclockwise, potentially impeding blood flow. The patient underwent emergency right upper lobectomy for torsion of the right upper lung lobe. He recovered uneventfully and was discharged without complications.

Conclusions: We experienced a rare case of spontaneous torsion of the right upper lung lobe caused by a large tumor and massive pleural effusion.

Keywords: Emergency lobectomy; Lung cancer; Pleural effusion; Spontaneous torsion.

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Figures

Fig. 1
Fig. 1
a Chest radiograph showing a large tumor shadow in the middle lung field and pleural effusion in the right cavity. b Scout image showing a large tumor shadow in the upper lung field. Note the change in position of the tumor
Fig. 2
Fig. 2
a Plain CT at first visit showing a large tumor mainly located at right S1-3, widely in contact with the precordial mediastinum and pleura. Massive pleural effusion in the right thoracic cavity is also present. Contrast-enhanced CT image at the onset of torsion, b lung window, c mediastinal window (enlarged image). The tumor in the right upper lung lobe has moved to the posterior thoracic space. There is a thrombus in the upper pulmonary vein (triangle) and non-contrast regions in the peripheral tumor (upward arrow), leading to suspicion of blood flow impediment
Fig. 3
Fig. 3
a Sagittal CT at the onset of torsion showed that the right upper lung lobe with the large tumor had rotated 90° counterclockwise toward the hilum. b Three-dimensional CT by the view of posterior showed that the middle and lower lung lobes had been pushed upward and forward respectively. The blank space showed a tumor. RUL right upper lobe, RML right middle lobe, RLL right lower lobe
See this image and copyright information in PMC

References

    1. Ohde Y, Nakagawa K, Okumura T, Kondo H. Spontaneous pulmonary torsion secondary to pseudo-meigs’ syndrome. Interact Cardiovasc Thorac Surg. 2005;4:59–60. - PubMed
    1. Irie M, Okumura N, Nakano J, Fujiwara A, Noguchi M, Kayawake H, et al. Spontaneous whole-lung torsion after massive pleural effusion and atelectasis. Ann Thorac Surg. 2014;97:329–32. doi: 10.1016/j.athoracsur.2013.04.133. - DOI - PubMed
    1. Trotter MC, McFadden PM, Ochsner JL. Spontaneous torsion of the right lung: a case report. Am Surg. 1995;61:306–309. - PubMed
    1. Bell MT, Kelmenson DA, Vargas D, Meguid RA. Spontaneous pulmonary torsion secondary to left upper lobe malignancy. J Thorac Oncol. 2015;10:1653–4. doi: 10.1097/JTO.0000000000000573. - DOI - PubMed
    1. Chrysou K, Gioutsos K, Filips A, Schmid R, Schmid RA, Kocher GJ. Spontaneous right whole-lung torsion secondary to bronchial carcinoma: a case report. J Cardiothorac Surg. 2016;11:107. doi: 10.1186/s13019-016-0506-z. - DOI - PMC - PubMed

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