title: Spontaneous right whole-lung torsion secondary to bronchial carcinoma: a case report.
abstract: BACKGROUND
  Spontaneous whole lung torsion is an absolut rarity and most cases occur after previous surgery.
  
  
  METHODS
  We present the case of a spontaneous whole-lung torsion in a 82-year old man. The patient was referred to our thoracic surgery department from the emergency department of a referring hospital with rapidly progressive dyspnea. CT-scan revealed a 180° degree counterclockwise torsion of the entire right lung with complete atelectasis and congestion of the upper lobe as well as pleural effusion. Thoracoscopy confirmed lung torsion and revealed hemorrhagic infarction of the upper lobe. Subsequently thoracotomy and upper lobectomy were performed. Most likely the lung torsion occurred due to a combination of pleural effusion and venous congestion with complete atelectasis of the upper lobe as a result of adenocarcinoma of the upper lobe.
  
  
  CONCLUSIONS
  To our knowledge this is the first reported case of a patient presenting with lung torsion as the first symptom of lung cancer. When lung torsion is suspected rapid diagnosis is crucial in order to prevent hemorrhagic lung infarction.
authors.affiliation: Division of General Thoracic Surgery, University Hospital of Bern, Bern, Switzerland.
authors.forename: Konstantina
authors.identifier: http://orcid.org/0000-0002-9203-1378
authors.initials: K
authors.lastname: Chrysou
authors.affiliation: Division of General Thoracic Surgery, University Hospital of Bern, Bern, Switzerland.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Gioutsos
authors.affiliation: Department of General Surgery, Buergerspital Solothurn, Solothurn, Switzerland.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Filips
authors.affiliation: Department of General Surgery, Buergerspital Solothurn, Solothurn, Switzerland.
authors.forename: Roger
authors.initials: R
authors.lastname: Schmid
authors.affiliation: Division of General Thoracic Surgery, University Hospital of Bern, Bern, Switzerland. ralph.schmid@insel.ch.
authors.forename: Ralph A
authors.initials: RA
authors.lastname: Schmid
authors.affiliation: Division of General Thoracic Surgery, University Hospital of Bern, Bern, Switzerland.
authors.forename: Gregor J
authors.initials: GJ
authors.lastname: Kocher
mesh_terms: D000230:Adenocarcinoma / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D000369:Aged, 80 and over; D002283:Carcinoma, Bronchogenic / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D008175:Lung Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D011013:Pneumonectomy; D014057:Tomography, X-Ray Computed; D014102:Torsion Abnormality / Q000000981:diagnostic imaging* / Q000209:etiology
keywords: Bronchial carcinoma; Case report; Lobectomy; Pulmonary torsion; Spontaneous lung torsion; Whole lung torsion