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

• Published in: BMJ case reports Vol. 15; no. 8; p. e249610
• Main Authors: Nguyen, Duy Thang, Vu, Ngoc Tu, Dinh, Thi Thanh Hong
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 02.08.2022; BMJ Publishing Group
• Subjects: Ablation; Aged; Aged, 80 and over; Biopsy; Cancer therapies; Case reports; Case Reports: Learning from unexpected outcome (positive or negative); Catheter Ablation - adverse effects; Chronic obstructive pulmonary disease; Colorectal cancer; Contraindications; COVID-19; Emphysema; Fistula; Humans; Liver cancer; Lung - diagnostic imaging; Lung - pathology; Lung - surgery; Lung cancer; Lung Neoplasms - pathology; Lung Neoplasms - surgery; Lymphatic system; Male; Metastasis; Microwaves - adverse effects; Necrosis; Necrosis - etiology; Necrosis - surgery; Octogenarians; Ostomy; Patients; Pneumothorax; Radiation therapy; Thoracic surgery; Tumors; Cardiothoracic surgery; Cancer intervention; Pneumothorax; Radiotherapy; Lung cancer (oncology)
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2022-249610

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.