Zusammenfassung
Das Auftreten einer bronchopleuralen Fistel ist eine ernste Komplikation nach Pneumonektomie aufgrund eines Lungenkarzinoms und die zusätzliche Bronchusstumpfdeckung gilt daher bei rechts- und linksseitiger Pneumonektomie als operativer Standard.
In dieser Kasuistik berichten wir von einer mittels FDG-PET/CT früh diagnostizierten Lymphknotenmetastase im zur Bronchusstumpfdeckung verwendeten perikardialen Fettlappen 8 Monate nach komplikationsloser Pneumonektomie der linken Lunge. Die lokoregionäre Lymphknotenrezidivmetastase wurde erfolgreich en bloc reseziert und die Rezidivregion einschließlich Mediastinum anschließend komplikationslos adjuvant bestrahlt.
Abstract
The occurrence of bronchopleural fistulas is a serious complication after pneumonectomy because of lung cancer and additional bronchial stump coverage within right-sided and left-sided pneumonectomy therefore constitutes the operative standard. This is a case report on the early diagnosis of a lymph node metastasis within the pedicled pericardial fat flap used for bronchial stump coverage. Primary resection of the left lung was carried out 8 months previously because of cancer. Early diagnosis was possible using FDG-PET/CT in the post-operative treatment. The recurrence was successfully treated by en bloc resection and adjuvant radiation.
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Fröhlich, J., Rischke, C., Rentschler, J. et al. Isolierte Lymphknotenmetastase im perikardialen Fettlappen nach Bronchusstumpfdeckung. Chirurg 81, 930–932 (2010). https://doi.org/10.1007/s00104-009-1839-0
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DOI: https://doi.org/10.1007/s00104-009-1839-0