Surgical management of delayed air leakage following radiofrequency ablation for non-small cell lung cancer: a case report

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® and Tisseel®) 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.