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Fatal contralateral pneumothorax in a patient with pneumonectomy.

A man in his 40s was transported to our hospital by ambulance with cardiopulmonary arrest. He was found unconscious at home at midnight. The patient had a monthly visit, but had no cough, sputum, or shortness of breath at the last visit. The patient was a never-smoker and had undergone a left pneumonectomy due to lung adenocarcinoma 6 years ago. Lung adenocarcinoma was stage IIIA pathologically, so the patient received postoperative chemotherapy. Since then, the patient has undergone chest CT scans several times, but no recurrence of lung adenocarcinoma was found. At this time, the patient was in cardiopulmonary arrest. The patient underwent endotracheal intubation and resuscitation. However, the patient did not respond and was confirmed dead. Autopsy was not permitted. Chest CT performed after death revealed a complete collapse of the right lung but no bullae was found (Figure 1-A). There was no pleural fluid or mediastinal lymphadenopathy. Since there was no recurrence of lung adenocarcinoma, it was evaluated that there was no association between pneumothorax and lung adenocarcinoma. Chest CT at 3 years and 4 years after resection of lung cancer showed a compensatory increase in the right lung over time (Figure 1-B and C), but no bullae was found in the right lung during the clinical course.