Management of lung nodules newly found by virtual-assisted lung mapping: a case report

Abstract Background Virtual-assisted lung mapping is a novel bronchoscopic lung marking technique that uses virtual images to perform multiple concurrent dye marking of barely palpable pulmonary tumors. Subsequent chest computed tomography is required to confirm the locations marked. We here report...

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Main Authors: Masahiro Yanagiya, Masaaki Sato, Hideki Kuwano, Kazuhiro Nagayama, Jun Nakajima
Format: Article
Language:English
Published: Japan Surgical Society 2017-03-01
Series:Surgical Case Reports
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Online Access:http://link.springer.com/article/10.1186/s40792-017-0327-x
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author Masahiro Yanagiya
Masaaki Sato
Hideki Kuwano
Kazuhiro Nagayama
Jun Nakajima
author_facet Masahiro Yanagiya
Masaaki Sato
Hideki Kuwano
Kazuhiro Nagayama
Jun Nakajima
author_sort Masahiro Yanagiya
collection DOAJ
description Abstract Background Virtual-assisted lung mapping is a novel bronchoscopic lung marking technique that uses virtual images to perform multiple concurrent dye marking of barely palpable pulmonary tumors. Subsequent chest computed tomography is required to confirm the locations marked. We here report a patient in whom computed tomography after virtual-assisted lung mapping unexpectedly revealed additional tiny pulmonary nodules. Case presentation A 64-year-old woman with a history of renal cell carcinoma presented with two pulmonary nodules suspicious of metastases from renal cell carcinoma. Because we anticipated that the nodules would be difficult to palpate intraoperatively, we performed virtual-assisted lung mapping prior to attempting to resect them. Computed tomography after mapping unexpectedly detected two additional nodules. Although the existing markings did not relate to the newly found nodules, we used imaginary auxiliary lines and anatomical landmarks to extend the lung map to incorporate the unexpected nodules. The additional nodules were successfully resected by thoracoscopic wedge resection. Pathologic examination identified all nodules as metastases from renal cell carcinoma, and the surgical margins were negative. Conclusions Imaginary auxiliary lines and anatomical landmarks extended the existing lung map of virtual-assisted lung mapping, enabling resection of unexpected pulmonary nodules found in post-mapping computed tomography images.
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spelling doaj-art-e22faf961ce849839ad51eb40ccd3be62025-08-20T03:19:07ZengJapan Surgical SocietySurgical Case Reports2198-77932017-03-01311410.1186/s40792-017-0327-xManagement of lung nodules newly found by virtual-assisted lung mapping: a case reportMasahiro Yanagiya0Masaaki Sato1Hideki Kuwano2Kazuhiro Nagayama3Jun Nakajima4Department of Thoracic Surgery, University of Tokyo, Graduate School of MedicineDepartment of Thoracic Surgery, University of Tokyo, Graduate School of MedicineDepartment of Thoracic Surgery, University of Tokyo, Graduate School of MedicineDepartment of Thoracic Surgery, University of Tokyo, Graduate School of MedicineDepartment of Thoracic Surgery, University of Tokyo, Graduate School of MedicineAbstract Background Virtual-assisted lung mapping is a novel bronchoscopic lung marking technique that uses virtual images to perform multiple concurrent dye marking of barely palpable pulmonary tumors. Subsequent chest computed tomography is required to confirm the locations marked. We here report a patient in whom computed tomography after virtual-assisted lung mapping unexpectedly revealed additional tiny pulmonary nodules. Case presentation A 64-year-old woman with a history of renal cell carcinoma presented with two pulmonary nodules suspicious of metastases from renal cell carcinoma. Because we anticipated that the nodules would be difficult to palpate intraoperatively, we performed virtual-assisted lung mapping prior to attempting to resect them. Computed tomography after mapping unexpectedly detected two additional nodules. Although the existing markings did not relate to the newly found nodules, we used imaginary auxiliary lines and anatomical landmarks to extend the lung map to incorporate the unexpected nodules. The additional nodules were successfully resected by thoracoscopic wedge resection. Pathologic examination identified all nodules as metastases from renal cell carcinoma, and the surgical margins were negative. Conclusions Imaginary auxiliary lines and anatomical landmarks extended the existing lung map of virtual-assisted lung mapping, enabling resection of unexpected pulmonary nodules found in post-mapping computed tomography images.http://link.springer.com/article/10.1186/s40792-017-0327-xThoracic surgeryMetastatic pulmonary tumorMarkingThoracoscopyBronchoscopy
spellingShingle Masahiro Yanagiya
Masaaki Sato
Hideki Kuwano
Kazuhiro Nagayama
Jun Nakajima
Management of lung nodules newly found by virtual-assisted lung mapping: a case report
Surgical Case Reports
Thoracic surgery
Metastatic pulmonary tumor
Marking
Thoracoscopy
Bronchoscopy
title Management of lung nodules newly found by virtual-assisted lung mapping: a case report
title_full Management of lung nodules newly found by virtual-assisted lung mapping: a case report
title_fullStr Management of lung nodules newly found by virtual-assisted lung mapping: a case report
title_full_unstemmed Management of lung nodules newly found by virtual-assisted lung mapping: a case report
title_short Management of lung nodules newly found by virtual-assisted lung mapping: a case report
title_sort management of lung nodules newly found by virtual assisted lung mapping a case report
topic Thoracic surgery
Metastatic pulmonary tumor
Marking
Thoracoscopy
Bronchoscopy
url http://link.springer.com/article/10.1186/s40792-017-0327-x
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