[Left Metastatic Lung Tumor for a Patient with Scimitar Syndrome:Report of a Case].
Hirotaka YukiDaisuke SaitoTetsuya TakayamaNobuhiro TanakaShuhei YoshidaKenji IinoHirofumi TakemuraIsao MatsumotoPublished in: Kyobu geka. The Japanese journal of thoracic surgery (2023)
Scimitar syndrome is a subtype of partial anomalous pulmonary venous connection, a rare congenital disorder associated with hypoplasia of the right lung. In addition to the difficulty of isolated lung ventilation, resection of the left lung is associated with the risk of developing right heart failure due to increased right-to-left shunts. We report a case of a left lung metastasis of a patient with scimitar syndrome. The patient, a 58-year-old male, was diagnosed with scimitar syndrome at the age of 26 but had never experienced any symptoms. He underwent chemoradiotherapy for mid-pharynx carcinoma and achieved complete response. During follow-up, a nodule appeared in the lower lobe of the left lung. Since right heart catheterization revealed a pulmonary blood flow/systemic blood flow ratio (Qp/Qs) ratio of 2.6, intra-cardiac blood flow was diverted prior to pulmonary resection. Stanford type A acute aortic dissection occurred intra-operatively, and total aortic arch replacement was performed. Three months later, partial pulmonary resection was performed with extracorporeal membrane oxygenation (ECMO) on standby. As oxygenation was maintained by placing a blocker in the left lower lobe bronchus and ventilating the left upper lobe with high frequency jet ventilation, the operation was completed without using ECMO. The nodule was pathologically diagnosed as metastasis of mid-pharynx carcinoma. He did not develop heart failure and was discharged on post operated day 15.
Keyphrases
- blood flow
- extracorporeal membrane oxygenation
- respiratory failure
- heart failure
- case report
- high frequency
- aortic dissection
- acute respiratory distress syndrome
- pulmonary hypertension
- transcranial magnetic stimulation
- left ventricular
- small cell lung cancer
- squamous cell carcinoma
- atrial fibrillation
- depressive symptoms
- radiation therapy
- rectal cancer
- liver failure
- sleep quality
- locally advanced
- physical activity
- drug induced
- single cell