Preoperative Empyema can be a Cause of Cancel Bronchial Sleeve Resection for Lung Cancer?

Surgical management of the cancer with empyema has rarely been reported in the literature because
few of such cases are operable. Many patients might be misevaluated because of the incorrect
staging associated with an acute or sub- acute infection. Even in the presence of an operable tumor
mass; surgeons behave timid to these patients because of the possibility of infective postoperative
complications. The balance between expected benefits and possible risk of surgical intervention is
also important. If it is indicated, by the time pleural empyema is restored, procedures such as
resection and even bronchoplasty should be performed. 59- years old patient the squamous cell
carcinoma had completely obstructed left basal segments and caused to empyema. A thoracic
catheter was inserted. Multiple pleural irrigations were done and proper antibiotherapy. Pathologic
diagnosis of pleural fluid and pleural biopsy were benign. Pleural cultures were negative and amount
of empyema fluid volume has decreased within two months. Positron emission tomography (PET)
revealed a 2,5 cm sized left infrahilar tumor, right paratracheal, prevascular and subcarinal lymph
nodes and non- homogeneous increased pleural activity. Mediastinal lymph nodes were evaluated as
reactive with mediastinoscopy. Left lower lobectomy and lingulectomy were performed with bronchial
resection and pathologic stage was 2A (T1bN1MO).