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Oh, Hyung‐Joo; Jeong, Won Gi; Lim, Yongwhan; Koh, Sang‐Joon; Lee, Sung Min; Kim, Min‐Seok; Koh, Bo‐Gun; Kim, Tae‐Ok; Choi, Yoo‐Duk; Oh, In‐Jae; Kim, Young‐Chul; Park, Cheol‐Kyu
Thoracic cancer, November 2020, Volume: 11, Issue: 11Journal Article
Air embolism is a rare, fatal complication of computed tomography (CT)‐guided transthoracic needle biopsy (TTNB) of the lung. Here, we report a patient who developed an air embolism after CT‐guided TTNB, which led to ST‐elevation myocardial infarction and acute cerebral ischemia. The patient recovered completely without critical sequelae and was diagnosed with adenocarcinoma harboring activating epidermal growth factor receptor (EGFR) mutation. The patient responded to subsequent treatment with gefitinib. Key points Signficant findings of the study Air embolism is a rare, fatal complication of CT‐guided transthoracic lung biopsy. Only a few cases have been previously reported where myocardial and cerebral infarction occurred after TTNB, demonstrated not only on CT scan, but also electrocardiogram and electroencephalogram. What this study adds Detection of driver gene mutation is crucial for planning lung cancer treatment. Despite the need for tissue biopsy, air embolism propagation to vital organs could result in severe end‐organ damage and multidisciplinary approaches are needed to improve initial outcomes. Systemic air embolism developed after CT‐guided TTNB, leading to ST‐elevation, myocardial infarction and acute ischemic stroke. The patient recovered completely without sequelae and was diagnosed with adenocarcinoma harboring activating EGFR mutation. Treatment with gefitinib showed a response.
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