Adult congenital lobar emphysema treated with video-assisted thoracoscopic lobectomy

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Congenital lobar emphysema (CLE) is a rare developmental anomaly of the lower respiratory tract, which generally presents during the neonatal/pediatric period.Lobectomy is the only curative treatment for CLE.An 18-year-old male with enlarging left anterior chest wall deformity and progressive breathlessness for the last 2 years admitted to our clinic.Physical examination revealed asymmetrical expansion of left hemithorax.Chest radiography and thoracic computed tomography demonstrated hyperinflation of the left upper lobe and a mediastinal shift to the right side.FEV1 was 1.70 L (50%).Ventilation-perfusion scintigraphy showed reduced perfusion and ventilation in the right lung to 33.4% (upper zone, 1.9%; middle zone, 10.0%; lower zone, 22.5%).Patient underwent a successful video-assisted thoracoscopic surgery (VATS) left upper lobectomy, and was discharged on postoperative day 5.He is still being followed-up on fifth year, asymptomatically, with normalized chest wall appearance.VATS lobectomy is a feasible, safe and effective treatment for congenital pulmonary disorders, even for delayed cases.