Rapid Improvement of Opaque Hemithorax Endobronchial Tumor Debulking using Electrocautery, Laser and Argon Plasma Coagulation
Keywords:Advanced stage lung cancer, argon plasma coagulation, electrocautery, laser, tumor debulking, medical thoracoscopy.
AbstractA 35-year-old nonsmoker male having history of seasonal asthma presented with one year history of respiratory symptoms and collapse right upper lobe which was not responding to anti tuberculous drugs. His chest CT scan showed tumor in right lung with extensive mediastinal adenopathy and distant bony and liver metastasis (stage IV lung cancer) and bronchoscopy revealed a lung cancer in right main bronchus that was adenocarcinoma on histology. This patient was reluctant for chemotherapy and over passage of time developed complete lung collapse on right side with worsening in respiratory symptomatology. He required sessions of endobronchial tumor debulking every few months utilizing electrocautery first time, endobronchial laser second time and argon plasma coagulation in the third procedure. Tumor debulking lead to remarkable improvement in his symptoms and chest radiographs. After the last endobronchial tumor debulking session he required medical thoracoscopy for pleurodesis after decompressing the pleural space filled with a large pleural effusion, providing him greater symptomatic relief. This case report highlights the palliative interventional bronchology procedures which can provide improvement in symptoms, quality of life and probably survival in patients with endobronchial cancer causing symptomatic airway obstruction.