{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T07:01:42Z","timestamp":1790146902914,"version":"4.0.1"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Radiol."],"abstract":"<jats:p>We report the case of a 68-year-old male with a history of urothelial carcinoma and severe emphysema who developed a delayed pneumothorax following CT-guided radiofrequency ablation (RFA) of a pulmonary squamous cell carcinoma. Conservative management with chest drainage failed to resolve the air leak. Surgical revision via uniportal video-assisted thoracic surgery (UVATS) allowed identification of a necrotic subpleural lesion with active air leakage. Hemostatic and sealing agents (Hemopatch\u00ae and Tisseel\u00ae) were applied with long-term resolution of the complication. This case underscores the importance of surgical intervention in selected cases of persistent air leak post-RFA and the potential efficacy of biologic sealants when resection is not feasible.<\/jats:p>","DOI":"10.3389\/fradi.2026.1815270","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:19:26Z","timestamp":1790144366000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical management of delayed air leakage following radiofrequency ablation for non-small cell lung cancer: a case report"],"prefix":"10.3389","volume":"6","author":[{"given":"Luca","family":"Frasca","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, Fondazione Policlinico Universitario Campus Bio-Medico","place":["Rome, Italy"]},{"name":"PhD Doctor in Microbiology, Immunology, Infectious Diseases, and Transplants (MIMIT), University Tor Vergata","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Suriano","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fondazione Policlinico Universitario Campus Bio-Medico","place":["Rome, Italy"]},{"name":"Fellowship in Department of Thoracic and Vascular Surgery, Avicenne Hospital","place":["Paris, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Sarubbi","sequence":"additional","affiliation":[{"name":"Master\u2019s Degree Program in Medicine and Surgery, Campus Bio-Medico University","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Longo","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fondazione Policlinico Universitario Campus Bio-Medico","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Canalella","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fondazione Policlinico Universitario Campus Bio-Medico","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliodoro","family":"Faiella","sequence":"additional","affiliation":[{"name":"Department of Radiology and Interventional Radiology, Fondazione Policlinico Universitario Campus Bio-Medico","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosario Francesco","family":"Grasso","sequence":"additional","affiliation":[{"name":"Department of Radiology and Interventional Radiology, Fondazione Policlinico Universitario Campus Bio-Medico","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierfilippo","family":"Crucitti","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fondazione Policlinico Universitario Campus Bio-Medico","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1779","DOI":"10.1016\/j.athoracsur.2010.07.033","article-title":"Surgical sealant for the prevention of prolonged air leak after lung resection: meta-analysis","volume":"90","author":"Malapert","year":"2010","journal-title":"Ann Thorac Surg"},{"key":"B2","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.ijscr.2018.03.038","article-title":"The use of a NHS-PEG coated, collagen-based sealant in a patient undergoing associating liver partition and portal vein ligation for staged hepatectomy (ALPPS)","volume":"47","author":"Olthof","year":"2018","journal-title":"Int J Surg Case Rep"},{"key":"B3","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1007\/978-3-642-71633-1_6","article-title":"The use of fibrin sealant (tissucol\/tisseel) in thoracic surgery","volume-title":"Fibrin Sealant in Operative Medicine","author":"Grunenwald","year":"1986"},{"key":"B4","doi-asserted-by":"publisher","first-page":"3727","DOI":"10.3390\/cancers16223727","article-title":"Changes in staging and management of non-small cell lung cancer patients following the implementation of low-dose chest computed tomography screening at Kaohsiung medical university hospital","volume":"16","author":"Chen","year":"2024","journal-title":"Cancers (Basel)"},{"key":"B5","article-title":"Squamous cell lung cancer","volume-title":"StatPearls [Internet]","author":"Sabbula","year":"2026"},{"key":"B6","doi-asserted-by":"publisher","first-page":"2273","DOI":"10.2147\/COPD.S210759","article-title":"Impact of underlying pulmonary diseases on treatment outcomes in early-stage non-small cell lung cancer treated with definitive radiotherapy","volume":"14","author":"Kim","year":"2019","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"B7","doi-asserted-by":"publisher","first-page":"3181","DOI":"10.1111\/1759-7714.15114","article-title":"Radiofrequency ablation for stage\u2009< IIB non-small cell lung cancer: opportunities, challenges, and the road ahead","volume":"14","author":"Zhao","year":"2023","journal-title":"Thorac Cancer"},{"key":"B8","doi-asserted-by":"publisher","first-page":"2800","DOI":"10.3390\/jcm14082800","article-title":"Diagnostic yield of CE-EBUS in mediastinal and hilar lymphadenopathy: a preliminary study","volume":"14","author":"Suriano","year":"2025","journal-title":"J Clin Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1634\/theoncologist.9-6-633","article-title":"The role of PET scan in diagnosis, staging, and management of non-small cell lung cancer","volume":"9","author":"Schrevens","year":"2004","journal-title":"Oncologist"},{"key":"B10","doi-asserted-by":"publisher","first-page":"2044","DOI":"10.1097\/JTO.0b013e31822d538d","article-title":"Long-term results of radiofrequency ablation treatment of stage I non-small cell lung cancer: a prospective intention-to-treat study","volume":"6","author":"Ambrogi","year":"2011","journal-title":"J Thorac Oncol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"323","DOI":"10.2214\/ajr.174.2.1740323","article-title":"Thermal ablation therapy for focal malignancy: a unified approach to underlying principles, techniques, and diagnostic imaging guidance","volume":"174","author":"Goldberg","year":"2000","journal-title":"AJR Am J Roentgenol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1016\/j.jacr.2018.10.012","article-title":"A meta-analysis of clinical outcomes after radiofrequency ablation and microwave ablation for lung cancer and pulmonary metastases","volume":"16","author":"Yuan","year":"2019","journal-title":"J Am Coll Radiol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1016\/j.ejrad.2018.01.009","article-title":"Efficacy and safety of radiofrequency ablation for lung cancers: a systematic review and meta-analysis","volume":"100","author":"Li","year":"2018","journal-title":"Eur J Radiol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1055\/s-0033-1342958","article-title":"Lung cancer ablation: complications","volume":"30","author":"Hiraki","year":"2013","journal-title":"Semin Intervent Radiol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1016\/j.jvir.2006.10.011","article-title":"Intractable pneumothorax due to bronchopleural fistula after radiofrequency ablation of lung tumors","volume":"18","author":"Sakurai","year":"2007","journal-title":"J Vasc Interv Radiol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1016\/j.chest.2017.02.020","article-title":"Management of persistent air leaks","volume":"152","author":"Dugan","year":"2017","journal-title":"Chest"},{"key":"B17","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1097\/MCP.0000000000001134","article-title":"The persistent problem of persistent air-leaks: approach to management","volume":"31","author":"Mundanchira","year":"2025","journal-title":"Curr Opin Pulm Med"},{"key":"B18","doi-asserted-by":"publisher","first-page":"CD011151","DOI":"10.1002\/14651858.CD011151.pub2","article-title":"Intraoperative use of low volume ventilation to decrease postoperative mortality, mechanical ventilation, lengths of stay and lung injury in patients without acute lung injury","volume":"12","author":"Guay","year":"2015","journal-title":"Cochrane Database Syst Rev"}],"container-title":["Frontiers in Radiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fradi.2026.1815270\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:19:27Z","timestamp":1790144367000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fradi.2026.1815270\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,23]]},"references-count":18,"alternative-id":["10.3389\/fradi.2026.1815270"],"URL":"https:\/\/doi.org\/10.3389\/fradi.2026.1815270","relation":{},"ISSN":["2673-8740"],"issn-type":[{"value":"2673-8740","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,23]]},"article-number":"1815270"}}