Lung cancer coincidentally found in the bulla

Several cases of lung cancer lying within giant bullae have been reported in recent years, such that some authors have considered an association between the two diseases. Giant bulla was detected on the chest X ray and thoracic computed tomography in a 50 year old man. Left lower lobectomy was performed for emphysematous lung destruction. The postoperative histopathological diagnosis was adeno carcinoma arising from the wall of giant bulla. It must be noted that occult cancer may exist at the wall of giant bullae, so annual radiological followup should be applied. On the basis of this experience and review of the literature, it is suggested that physicians should always pay careful attention to the generation and complication of cancer while treating bullous disease in heavy smoking individuals. © 2008 Indian Association of Cardiovascular-Thoracic Surgeons.