J Lung Cancer.  2011 Dec;10(2):102-104. 10.6058/jlc.2011.10.2.102.

Fatal Broncho-Mediastinal Fistula in a Patient with Non-Small Cell Lung Cancer after Photodynamic Therapy

• Heo EY
• Kim YJ
• Yang SC

• KMID: 2005741
• DOI: http://doi.org/10.6058/jlc.2011.10.2.102

Abstract

Photodynamic therapy (PDT) can be used as palliative therapy to reduce obstructive symptoms in patients with advanced lung cancer. Herein, we report on the case of a patient with fatal broncho-mediastinal fistula after PDT. A 57-year-old woman was diagnosed as non-small cell lung cancer (squamous cell carcinoma, cT4N3). She received PDT on the endobronchial mass obstructing her right main bronchus twice in 48 hours interval. Two weeks later, concurrent chemoradiation therapy (CCRT) with weekly Paclitaxel/Carboplatin was started. During maintenance chemotherapy, a new nodule in her scalp developed and turned out to be a metastatic nodule. A broncho-mediastinal fistula was suspicious on follow-up chest computed tomography and a broncoscopy revealed an extensively damaged medial right main bronchial wall. On the day following bronchoscopy, the patient died of sudden massive hemoptysis.

Keyword

Lung cancer; Photodynamic therapy

MeSH Terms

Bronchi
Bronchoscopy
Carcinoma, Non-Small-Cell Lung
Female
Fistula
Follow-Up Studies
Hemoptysis
Humans
Lung Neoplasms
Maintenance Chemotherapy
Middle Aged
Palliative Care
Photochemotherapy
Scalp
Thorax
Triazenes
Triazenes

Figure

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  Fig. 1. Chest CT finding of bron-cho-mediastinal fistula after photodynamic therapy and concurrent chemoradiation therapy.

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  Fig. 2. Bronchoscopic finding of extensively damaged carina and the medial wall of right main bronchus (A, carina; B, right main bronchus).

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