Right Pneumonectomy for a Lung Abscess Complicated by a Metastatic Lung Tumor from Uterine Cervical Cancer: A Case Report

Lung abscesses are necrotic cavities whose management is particularly complex when associated with malignant tumors, and there is no consensus on optimal strategies. We describe a patient with a metastatic lung tumor complicated by abscess. Thoracoscopic drainage achieved temporary control and allowed chemotherapy, but recurrence of the abscess required urgent pneumonectomy. A 52-year-old woman with Stage IIIB uterine cervical squamous cell carcinoma achieved a complete response to chemoradiotherapy but presented two years later with a cavitary mass in the right upper lobe. Biopsy confirmed metastatic recurrence. Positron emission tomography revealed increased uptake in the mass and cervical lymph nodes, and the diagnosis was multiple metastases. Before the planned initiation of systemic therapy, the patient developed a high fever and was diagnosed with obstructive pneumonia and a lung abscess. Emergency thoracoscopic drainage was performed. After temporary improvement, recurrent infection after the resumption of systemic therapy led to the decision to perform an urgent right pneumonectomy. The patient recovered well, resumed systemic therapy for residual lesions, and remained disease-free at 47 months postoperatively. We report a challenging case of a metastatic lung tumor from uterine cervical cancer complicated by a severe lung abscess that worsened after chemotherapy following thoracoscopic drainage, ultimately requiring urgent pneumonectomy. This case underscores the difficulty of balancing infection control and oncologic treatment in such patients.