Left pneumonectomy for primary lung cancer with Trousseau's syndrome

Abstract

Trousseau's syndrome is a paraneoplastic syndrome and a pathological condition that causes cerebral stroke symptoms due to hypercoagulation associated with malignant tumours. There have been many cases of advanced lung cancer, but few reports have described surgery for lung cancer with Trousseau's syndrome. We encountered a 76-year-old man suspected of having Trousseau's syndrome associated with lung cancer. He was transferred to our hospital on the second day after the onset. After admission, he was treated with heparin and edaravone, and his condition improved. On the 12th day after the onset, we performed left pneumonectomy and lymph node dissection (ND2a-2). The final pathological results were adenocarcinoma, pathological stage was T4 (tumour size: 77 mm, pulmonary artery invasion) N1(#11, #12u) M0, stage IIIA. He has been recurrence free for 23 months since the surgery. In the future, we need to follow his condition carefully.

Keywords: cardiothoracic surgery; lung cancer (oncology); surgery.

Figure 1

Chest CT shows a 77 mm tumour mass in the upper left lobe.

Figure 2

On chest CT, the tumour had partially invaded the pulmonary artery (A3).

Figure 3

Head MRI shows a high signal on T2-weighted imaging in the right cerebral hemisphere region.

Figure 4

Pathological findings. The tumour was 77×72 mm in size. The postoperative pathological diagnosis was adenocarcinoma with N1 (#11, #12 u) lymph node metastasis (H＆E stain; magnification,×400).