Bronchopleural fistula after non small cell lung cancer radiofrequency ablation: what it implying to us?

Radiofrequency ablation (RFA) is an alternative method to treat the inoperable NSCLC and there were few serious complications after RFA therapy have been reported. Here, we reported a NSCLC patient endured empyema after treatment by RFA for one month. There was a 20 × 25 × 20 mm mass on the right middle lobe by CT scan before RFA and a huge gas cavity with liquid was found in the right chest cavity after RFA treatment for twenty- eight days. A hole in the right middle lobe was found with large amount of pus in the pleural cavity as well as the bronchopleural fistula (BPF) during the operation. Results from the postoperative pathology showed a multiple small foci differentiated adenocarcinoma, partial bronchiolar-alveolar carcinoma, 0.5 cm away around the hole at the same time. It is difficult to diagnose and treat the rare complication of BPF, while, the larger field of ablation might be helpful to postpone the tumor local progression. Therefore, surgery was a good option for BPF especially when an empyema occurred. Virtual slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/8028049341122276.