[A case of small cell carcinoma originating at the site of pneumoplication of giant bulla five years later].

A 64 year-old man was performed pneumoplication for his left-sided giant bulla on December 15, 1983. After five years, consciousness loss and right hemiplegia occurred. Brain CT revealed a cystic lesion with enhancement in the left occipital lobe. Brain biopsy disclosed metastatic small cell carcinoma. Lung biopsy showed the same histopathology, so primary lesion was considered to be from the site of the previous pneumoplication. Lung cancer associated with emphysematous bulla have been mostly characterized by tumor shadow or niveáu in the bulla. In this case, the postoperative infiltrating shadow of pneumoplication had made early diagnosis difficult.