Current Thoracic Surgery
2025 , Vol 10 , Issue 3
Treatment of contralateral pneumothorax due to metastasis in a left pneumonectomy patient with single-port VATS
1Department of Thoracic Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey2Department of Thoracic Surgery, Kartal Dr. Lütfi Kırdar City Hospital, Istanbul, Turkey DOI : 10.26663/cts.2025.028 Viewed : 7 - Downloaded : 5 Spontaneous pneumothorax secondary to pulmonary metastasis is a rare but critical condition, particularly when it occurs in the single remaining lung of a patient who has undergone pneumonectomy. We present the case of a 62-year-old male with a history of left pneumonectomy for a malignant mesenchymal tumor who developed a right-sided pneumothorax one year postoperatively. Due to a persistent air leak resistant to tube thoracostomy, a chest CT was performed, revealing a subpleural metastatic lesion. The patient successfully underwent single-port Video-Assisted Thoracoscopic Surgery (VATS) wedge resection and apical pleurectomy under general anesthesia with transient apnea. This case highlights that despite the limited pulmonary reserve in pneumonectomized patients, single-port VATS offers a safe and effective approach for the definitive management of secondary pneumothorax caused by metastasis in the contralateral lung. Keywords : pneumonectomy, pneumothorax, video-assisted thoracic surgery, lung neoplasms, neoplasm metastasis