Incidental carcinoma in bullous emphysema

Bullous disease of the lung and pneumothorax are both frequent conditions in thoracic surgery.1 Lung cancer may develop in patients with bullous emphysema,1,2 lung cysts3 and pneumothorax,4 which are usually treated as benign diseases; however, pulmonary carcinoma associated with bullous emphysema is unusual. We report the case of a patient who presented with right spontaneous pneumothorax that was managed surgically through tube thoracostomy followed by minithoracotomy and excision of a right apical bulla. Pathological examination revealed a poorly differentiated non–small cell lung carcinoma (NSCLC), and the patient underwent a right upper lobectomy as final treatment.