Intercostal lung herniation is defined as a protrusion of the lung parenchyma through a defect in the intercostal muscles between adjacent ribs. The authors report a case of intercostal pulmonary hernia in a 45-year-old male patient, with smoking habit (30 packs-year), presented to the emergency department with dyspnea. He had the history of pulmonary emphysema complicated with a total right pneumothorax in 2015 treated by mini-thoracotomy with bullectomy and pleural abrasion. In 2019, he was admitted to hospital for left chest pain. The computed tomography (CT) scan of the chest revealed a bilateral emphysema with intercostal lung hernia through the fourth intercostal space the patient underwent, a left thoracotomy with repair of the intercostal muscle defect. He was discharged from hospital free of complications.

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The overall prognosis in patients with advanced and metastatic lung cancer is poor, however a subset of these patients has durable survival and they are called long-term survivors (LS). The definition of LS varies in published series from 18 months to 5 years. Few studies have focused on them. We report six cases of LS patients: three cases of non-small-cell lung cancer (stage IIIB and stage IV), two cases of small cell lung cancer, and a case of composite carcinoma (small cell carcinoma and squamous carcinoma), all having a survival of five years or more. Our patients show clinical and evolutionary similarities with LS in the literature regarding the prognostic factors associated with prolonged survival performance status and good response to first-line chemotherapy.