Impact of lung cancer surgery on comorbid Mycobacterium avium complex lung disease—A case series. (2022)

• Record Type: Journal Article
• Authors: Tamura, Atsuhisa; Kawashima, Masahiro; Suzuki, Junko; Yamane, Akira; Inoue, Yuta; Fukami, Takeshi; Kitani, Masashi; Takahashi, Fumiaki
• Is Part Of: Respiratory medicine case reports. Volume 37(2022)
• Publication Date: 2022
• Subjects: Case report -- Lung cancer surgery -- Mycobacterium avium complex Lung disease -- Comorbidity -- Exacerbation -- Rifampicin -- Ethambutol -- And clarithromycin therapy; Respiratory organs -- Diseases -- Periodicals; Chest -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Respiratory System -- Periodicals; Chest -- Diseases; Respiratory organs -- Diseases; Electronic journals; Periodicals; 616.2
• DOI: 10.1016/j.rmcr.2022.101664
• Languages: English
• ISSNs: 2213-0071

Abstract

Abstract: The number of cases with Mycobacterium avium and Mycobacterium intracellulare lung diseases (Mycobacterium avium complex lung disease [MACLD ]) are increasing globally. Lung cancer can sometimes present as a comorbidity with MACLD; however, the clinical presentation and outcomes of comorbid MACLD following lung cancer resection remain unclear. Therefore, we retrospectively assessed 17 patients with MACLD undergoing lung cancer resection to determine the impact of lung cancer surgery on comorbid MACLD. Of the 17 patients, Mycobacterium avium and Mycobacterium intracellulare were present in 15 and 2 patients, respectively; 14 patients had stage I lung cancer and underwent lobectomy. Ten patients were postoperatively observed for MACLD without any further intervention, five patients underwent additional resection for conspicuous MACLD lesions, and the remaining two patients underwent complete resection for MACLD and lung cancer within the same lobe followed by rifampicin, ethambutol, and clarithromycin (RECAM) therapy. Seven patients exhibited postoperative MACLD exacerbation, six of whom developed exacerbation in the operated ipsilateral residual lobes. Six of these seven patients received RECAM, three of whom (43%) subsequently exhibited improvement. Attention should be paid to MACLD exacerbation during postoperative follow-up, especially in ipsilateral lobes. Although RECAM therapy may be beneficial in alleviating MACLD exacerbation, further investigation is warranted to validate these results. Highlights: Impact of lung cancer surgery on comorbid M. avium complex lung disease is unclear. Lung cancer resection can be followed by MACLD exacerbation in a short period. Rifampicin, ethambutol and clarithromycin therapy can be tried for MACLD exacerbation.