Pleural Covering Application for Recurrent Pneumothorax in a
Birt-Hogg-Dubé syndrome (BHDS), a hereditary genodermatosis caused by a germline folliculin (FLCN) mutation, was first described in 1975 and 1977.1,2) The thoracic manifestations of this syndrome are multiple lung cysts and pneumothorax with frequent recurrences.3) These cysts appear predominantly at the lower-medial zone of the lung field and adjacent to the interlobar fissure but sometimes abut peripheral pulmonary vessels.4,5) Thus, the conventional surgical approach in which all subpleural cysts and bullae are resected is not feasible for the management of pneumothorax in BHDS. Here, we describe a patient with BHDS whose recurrent pneumothorax was successfully resolved by applying a pleural covering technique during thoracoscopic surgery.6) This procedure was effective in preventing further recurrence.

A 30-year-old male presented at the emergency department of our hospital, complaining of a sudden left-sided chest pain. A chest X-ray and computed tomography showed collapse of the left lung and multiple lung cysts. He was diagnosed with left-sided pneumothorax and treated with the insertion of a portable drainage kit (Thoracic Egg®, Sumitomo Bakelite CO., Ltd. Tokyo, Japan), that enables to manage him in a setting of outpatient clinic. One-week after insertion of the tube, resolution of the pneumothorax enabled removal of the chest drainage tube....