Massive lung necrosis due to microwave ablation in an octogenarian required urgent lobectomy

Abstract

We present a rare complication of microwave ablation (MWA) in a male patient in his 80s. His massive pulmonary necrosis and tension pneumothorax required urgent surgery. However, the damage to the lung tissue was too large, deep and fragile. We failed to suture or conduct wedge resection on the lung lesion, so, left upper lobectomy was necessary. Therefore, we suggest that it is probably possible to reduce the frequency and time threshold when performing MWA for the elderly with comorbidities.

Emergency Surgical Intervention in Microwave Ablation-Induced Massive Lung Necrosis

“…The only reported case of massive lung necrosis after MWA involved an elderly male patient in his 80s diagnosed with lung squamous cell carcinoma [ 5 ]. On the fourth day post-MWA, the development of pneumothorax and dyspnea and failure to manage the symptoms resulted in an urgent left upper lobectomy [ 5 ].…”

“…The only reported case of massive lung necrosis after MWA involved an elderly male patient in his 80s diagnosed with lung squamous cell carcinoma [ 5 ]. On the fourth day post-MWA, the development of pneumothorax and dyspnea and failure to manage the symptoms resulted in an urgent left upper lobectomy [ 5 ]. The authors suggested that the elastic properties of the lung tissue in the elderly are more fragile, requiring a reduced frequency and time threshold when performing MWA in this population [ 5 ].…”

“…On the fourth day post-MWA, the development of pneumothorax and dyspnea and failure to manage the symptoms resulted in an urgent left upper lobectomy [ 5 ]. The authors suggested that the elastic properties of the lung tissue in the elderly are more fragile, requiring a reduced frequency and time threshold when performing MWA in this population [ 5 ]. However, massive necrosis in our 33-year-old patient raises questions about potential contributing factors in younger individuals, such as tumor location and characteristics or technical aspects of the procedure.…”