Balawi A, Gamondes J P, Trillet V, Jegaden O, Thevenet F, Loire R
Service de Chirurgie Thoracique, Hôpital Cardiologique et Pneumologique Louis Pradel, Lyon.
Ann Chir. 1991;45(8):683-7.
We report a case illustrating the therapeutic consequences of an intravenous metastasis to the left superior pulmonary vein following resection of a voluminous primary lung carcinoma. Arterial spread of malignant cells occurred because the size of the tumor did not allow immediate clamping of the left superior pulmonary vein. The embolism was situated at the aortic bifurcation and lower limb ischemia persisted despite also emergency embolectomy. Distal (lower popliteal) embolectomy was also unsuccessful, and lower limb amputation was inevitable. This case illustrates the problems encountered in surgical treatment of pulmonary vein invasion by lung carcinoma and the role of adjuvant chemotherapy and radiotherapy.
我们报告一例病例，该病例显示了在切除巨大原发性肺癌后，癌细胞经静脉转移至左上肺静脉的治疗后果。由于肿瘤体积较大，无法立即钳夹左上肺静脉，导致恶性细胞发生动脉播散。栓子位于主动脉分叉处，尽管进行了急诊栓子切除术，但下肢缺血仍持续存在。远端（腘动脉下段）栓子切除术也未成功，下肢截肢不可避免。该病例说明了肺癌侵犯肺静脉手术治疗中遇到的问题以及辅助化疗和放疗的作用。
