The patient also had history of pulmonary tuberculosis 10 years ago, for which he took anti-tubercular treatment for 12 months and was declared cured. During the VATS bullectomy, we found a dense pleural adhesion in the left hemithorax, which makes the surgery much more difficult, fortunately, the post-operation recovery is uneventful.

Vanishing lung syndrome was first reported by Burke in 1937 ¹, Roberts first presents the radiographic criteria for this condition: the presence of a giant bulla in one or more upper lobes (mostly unilateral), occupying at least one-third of the hemithorax and compressing surrounding normal lung parenchyma ².

Giant bullous emphysema is most frequent in young male smokers ³. Pulmonary bullae are also associated with primary lung cancer, the incidence is 4.2% reported by Venuta, so a strict follow up is required ⁴.