Metastatic lung tumor from hepatocellular carcinoma with tumor thrombus invasion in the pulmonary vein: a case report
Abstract Background Metastatic lung tumor with a tumor thrombus in the peripheral pulmonary vein is very rare. We present a case of a metastatic lung tumor from hepatocellular carcinoma (HCC) with tumor thrombus invasion in the pulmonary vein that was diagnosed preoperatively and underwent complete...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13019-023-02230-4 |
| _version_ | 1827956592487694336 |
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| author | Kazuto Ohtaka Setsuyuki Ohtake Yu Ishii Saya Kaku Yuta Takeuchi Tomoko Mizota Yoshiyuki Yamamura Masaomi Ichinokawa Tatsuya Yoshioka Eiji Tamoto Katsuhiko Murakawa Koichi Ono |
| author_facet | Kazuto Ohtaka Setsuyuki Ohtake Yu Ishii Saya Kaku Yuta Takeuchi Tomoko Mizota Yoshiyuki Yamamura Masaomi Ichinokawa Tatsuya Yoshioka Eiji Tamoto Katsuhiko Murakawa Koichi Ono |
| author_sort | Kazuto Ohtaka |
| collection | DOAJ |
| description | Abstract Background Metastatic lung tumor with a tumor thrombus in the peripheral pulmonary vein is very rare. We present a case of a metastatic lung tumor from hepatocellular carcinoma (HCC) with tumor thrombus invasion in the pulmonary vein that was diagnosed preoperatively and underwent complete resection by segmentectomy. Case presentation A 77-year-old man underwent laparoscopic lateral segment hepatectomy for HCC eight years ago. Protein induced by vitamin K absence or antagonist-II remained elevated from two years ago. Contrast-enhanced chest computed-tomography (CT) showed a 27 mm nodule in the right apical segment (S1). He was pathologically diagnosed with a metastatic lung tumor from HCC via transbronchoscopic biopsy. We planned to perform right S1 segmentectomy. Before surgery, contrast-enhanced CT in the pulmonary vessels phase for three-dimensional reconstruction showed that the tumor extended into the adjusting peripheral pulmonary vein, and we diagnosed tumor thrombus invasion in V1a. The surgery was conducted under 3-port video-assisted thoracic surgery. First, V1 was ligated and cut. A1 and B1 were cut. The intersegmental plane was cut with mechanical staplers. Pathological examination revealed moderately-differentiated metastatic HCC with tumor thrombus invasions in many pulmonary veins, including V1a. No additional postoperative treatments were performed. Conclusions As malignant tumors tend to develop a tumor thrombus in the primary tumor, it might be necessary to perform contrast-enhanced CT in the pulmonary vessel phase to check for a tumor thrombus before the operation for metastatic lung tumors. |
| first_indexed | 2024-04-09T15:06:24Z |
| format | Article |
| id | doaj.art-73640a3012b04890a698ce9ffdad282a |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-04-09T15:06:24Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-73640a3012b04890a698ce9ffdad282a2023-04-30T11:27:42ZengBMCJournal of Cardiothoracic Surgery1749-80902023-04-011811610.1186/s13019-023-02230-4Metastatic lung tumor from hepatocellular carcinoma with tumor thrombus invasion in the pulmonary vein: a case reportKazuto Ohtaka0Setsuyuki Ohtake1Yu Ishii2Saya Kaku3Yuta Takeuchi4Tomoko Mizota5Yoshiyuki Yamamura6Masaomi Ichinokawa7Tatsuya Yoshioka8Eiji Tamoto9Katsuhiko Murakawa10Koichi Ono11Department of Surgery, Obihiro Kosei General HospitalDepartment of Surgery, Obihiro Kosei General HospitalDepartment of Surgery, Obihiro Kosei General HospitalDepartment of Surgery, Obihiro Kosei General HospitalDepartment of Surgery, Obihiro Kosei General HospitalDepartment of Surgery, Obihiro Kosei General HospitalDepartment of Surgery, Obihiro Kosei General HospitalDepartment of Surgery, Obihiro Kosei General HospitalDepartment of Surgery, Obihiro Kosei General HospitalDepartment of Surgery, Obihiro Kosei General HospitalDepartment of Surgery, Obihiro Kosei General HospitalDepartment of Surgery, Obihiro Kosei General HospitalAbstract Background Metastatic lung tumor with a tumor thrombus in the peripheral pulmonary vein is very rare. We present a case of a metastatic lung tumor from hepatocellular carcinoma (HCC) with tumor thrombus invasion in the pulmonary vein that was diagnosed preoperatively and underwent complete resection by segmentectomy. Case presentation A 77-year-old man underwent laparoscopic lateral segment hepatectomy for HCC eight years ago. Protein induced by vitamin K absence or antagonist-II remained elevated from two years ago. Contrast-enhanced chest computed-tomography (CT) showed a 27 mm nodule in the right apical segment (S1). He was pathologically diagnosed with a metastatic lung tumor from HCC via transbronchoscopic biopsy. We planned to perform right S1 segmentectomy. Before surgery, contrast-enhanced CT in the pulmonary vessels phase for three-dimensional reconstruction showed that the tumor extended into the adjusting peripheral pulmonary vein, and we diagnosed tumor thrombus invasion in V1a. The surgery was conducted under 3-port video-assisted thoracic surgery. First, V1 was ligated and cut. A1 and B1 were cut. The intersegmental plane was cut with mechanical staplers. Pathological examination revealed moderately-differentiated metastatic HCC with tumor thrombus invasions in many pulmonary veins, including V1a. No additional postoperative treatments were performed. Conclusions As malignant tumors tend to develop a tumor thrombus in the primary tumor, it might be necessary to perform contrast-enhanced CT in the pulmonary vessel phase to check for a tumor thrombus before the operation for metastatic lung tumors.https://doi.org/10.1186/s13019-023-02230-4Hepatocellular carcinomaMetastatic lung tumorTumor thrombusSegmentectomyThree-dimensional computed tomography |
| spellingShingle | Kazuto Ohtaka Setsuyuki Ohtake Yu Ishii Saya Kaku Yuta Takeuchi Tomoko Mizota Yoshiyuki Yamamura Masaomi Ichinokawa Tatsuya Yoshioka Eiji Tamoto Katsuhiko Murakawa Koichi Ono Metastatic lung tumor from hepatocellular carcinoma with tumor thrombus invasion in the pulmonary vein: a case report Journal of Cardiothoracic Surgery Hepatocellular carcinoma Metastatic lung tumor Tumor thrombus Segmentectomy Three-dimensional computed tomography |
| title | Metastatic lung tumor from hepatocellular carcinoma with tumor thrombus invasion in the pulmonary vein: a case report |
| title_full | Metastatic lung tumor from hepatocellular carcinoma with tumor thrombus invasion in the pulmonary vein: a case report |
| title_fullStr | Metastatic lung tumor from hepatocellular carcinoma with tumor thrombus invasion in the pulmonary vein: a case report |
| title_full_unstemmed | Metastatic lung tumor from hepatocellular carcinoma with tumor thrombus invasion in the pulmonary vein: a case report |
| title_short | Metastatic lung tumor from hepatocellular carcinoma with tumor thrombus invasion in the pulmonary vein: a case report |
| title_sort | metastatic lung tumor from hepatocellular carcinoma with tumor thrombus invasion in the pulmonary vein a case report |
| topic | Hepatocellular carcinoma Metastatic lung tumor Tumor thrombus Segmentectomy Three-dimensional computed tomography |
| url | https://doi.org/10.1186/s13019-023-02230-4 |
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