Bilateral Chylothorax Following Neck Dissection: Case Report & Review of Literature

Abstract

Bilateral Chylothorax following neck dissection is an extremely rare complication. We report a case of bilateral chylothorax detected after neck dissection for carcinoma of lower alveolus. A 61 year Indian female underwent wide excision with segmental mandibulectomy with comprehensive neck dissection for carcinoma of left lower alveolus clinically staged T4N0. Evaluated for dyspnea in post operative period, she was found to have bilateral chylothorax that was managed conservatively. This case report presents potentially life threatening complication following neck dissection that often responds to non surgical management.

An Unusual Case of Bilateral Chylothorax After Neck Dissection

“…Bilateral chylothorax affects the cardiorespiratory system by reducing the vital capacity and venous return. Moreover, it also has a severe nutritional and hydroelectrolytic effect …”

Bilateral Chylothorax Following Left Neck Dissection and Literature Review

“…Chylous stula of the neck, which is related to the occurrence of chylothorax 6) , was reported in 2% of cases following neck dissection 14) , and chylothorax with chylous stula of the neck is reported to be 0.2% 6) . Moreover, only 9 cases of chylothorax without chylous stula were reported in the literature [7][8][9][10][11][12][13] , associated with head and neck cancer. The primary tumor included 4 cases of thyroid cancer, 2 cases of tongue cancer, 2 cases of laryngeal cancer, 1 case of lower gingival cancer, and 1 case of oral malignant melanoma (Table 1).…”

“…Moreover, only 9 cases of chylothorax without chylous stula were reported in the literature [7][8][9][10][11][12][13] , associated with head and neck cancer. The diagnosis of chylothorax without chylous stula was relatively di cult because of its rarity and the lack of visible ndings such as neck swelling or white uid in the drain tube in the early postoperative stage.…”

Chylothorax

“…Hier kann zwischen dem iatrogenen (chirurgisch bedingt) und dem nichtiatrogenen Trauma unterschieden werden. Das höchste Risiko für einen chirurgisch bedingten Chylothorax besteht bei der Ösophagusresektion (2-3 %), gefolgt von der mediastinalen Lymphadenektomie in Rahmen von onkologischen Lungeneingriffen, dem koronar-arteriellen Bypass und der radikalen Neck dissection (Cerfolio et al 1996;Bolger et al 1991;Singh et al 2016). Ebenfalls kann eine Thrombose bedingt durch einen zentralvenösen Katheter in der Vena subclavia eine Obstruktion des Ductus thoracicus hervorrufen (Siu et al 2012).…”