Kishimoto Kazuya, Izumi Nobuhiro, Kinoshita Hirotaka, Tanimura Takuya, Suzuki Satoshi, Hara Kantaro, Inoue Hidetoshi, Tsukioka Takuma, Shiohara Masanori, Odagiri Naoshi, Soh Junichi
Department of Thoracic Surgery, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.
Department of Pathology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.
Respir Med Case Rep. 2025 May 13;56:102233. doi: 10.1016/j.rmcr.2025.102233. eCollection 2025.
A 71-year-old man was started on 12 mg/day of lenvatinib for lung metastasis from hepatocellular carcinoma (HCC). The day after starting treatment, he developed hemoptysis, and a CT scan revealed a rupture of the left upper lobe metastasis, accompanied by pulmonary hemorrhage. Angiography was performed, and the responsible blood vessels, the bronchial artery and the left pulmonary artery (A1+2ab), were embolized. One week later, the patient developed a left tension pneumothorax. Despite thoracic drainage, air leakage and bloody drainage persisted. We decided to perform a left upper lobe resection to control the bleeding and air leakage. A 10-cm necrotic lesion was found in the left upper lobe, and the pleura between the lobes had ruptured, causing a hematoma to drain into the pleural cavity. We encountered a case of hemopneumothorax resulting from the rupture of lung metastases from HCC during treatment with lenvatinib.
一名71岁男性因肝细胞癌（HCC）肺转移开始接受每日12毫克乐伐替尼治疗。开始治疗后的第二天，他出现咯血，CT扫描显示左上叶转移灶破裂，并伴有肺出血。进行了血管造影，并对责任血管，即支气管动脉和左肺动脉（A1+2ab）进行了栓塞。一周后，患者出现左侧张力性气胸。尽管进行了胸腔引流，但仍持续存在漏气和血性引流。我们决定进行左上叶切除术以控制出血和漏气。在左上叶发现一个10厘米的坏死病灶，并发现叶间胸膜破裂，导致血肿流入胸腔。我们遇到了一例在乐伐替尼治疗期间HCC肺转移灶破裂导致血气胸的病例。
