Postoperative bronchopleural fistula after induction therapy with bevacizumab.

Bronchopleural fistulas are rare complications of bevacizumab treatment. Herein, we report a case of bronchopleural fistula after bevacizumab therapy. The patient was a 65-year-old man with lung cancer who underwent a right lower lobectomy with systemic lymph node dissection after induction chemotherapy with bevacizumab. Pathological examination revealed no residual tumor cells in the resected specimen. The patient presented with severe dyspnea on postoperative day 26. Bronchoscopy revealed a bronchopleural fistula in the membranous portion of the right intermediate bronchus; the bronchial stump remained intact. The bronchopleural fistula was repaired with muscle flaps, and bronchoscopy 9 months after surgery showed satisfactory healing of the fistula. The patient has been alive for 5 years without evidence of recurrence. Careful attention must be paid to postoperative management when bevacizumab is used for induction therapy.