VARIOUS ASPECTS OF SURGERY FOR CARCINOMA DEVELOPING IN A CONTEXT OF SEVERE BULLOUS EMPHYSEMA

The authors report the case of a 64-year-old patient with a peripheral tumour of the left upper lobe developing in a context of bilateral major lesions of bullous emphysema with predominance on the right. Surgery first enabled the resection of large dystrophic compressive bullae of the right upper lobe, then, secondly, atypical resection of the culmen for excision of the peripheral tumour and dystrophic bullae of the left upper lobe. Twelve months later, a tumour recurrence led to left total pneumonectomy. Two radically different surgical approaches for carcinoma in a context of severe bullous emphysema are illustrated by this same patient. While the objective of functional improvement was associated with the oncological quality of excision at the time of the first stage of treatment, it was subsequently possible to perform major excision surgery with notable loss of functional capacity thanks to the benefits of the first operation.