Akimaru K, Miyairi K, Tanaka H, Imai S, Iwase I, Uchiyama K, Shibuya T, Shoji T
Department of Surgery, First Hospital of Nippon Medical School, Tokyo, Japan.
J Gastroenterol Hepatol. 1993 Nov-Dec;8(6):613-5. doi: 10.1111/j.1440-1746.1993.tb01661.x.
A 67 year old male with non-resectable hepatocellular carcinoma (HCC) in both lobes and liver cirrhosis was treated with transcatheter arterial embolization and regional chemotherapy. He was doing well for 18 months. He was readmitted for fever, chest pain and multiple pulmonary metastases. During interleukin-2 therapy, he suddenly developed dyspnoea and palpitation, and was in shock. Left-sided haemothorax was confirmed by draining 3 L of fresh blood. In spite of intensive care, he died within 36 h. Autopsy showed that the haemothorax was caused by rupture of one of the metastases in the upper lobe of the left lung, and that the primary HCC was totally necrotic. Survey of the literature failed to find a report of fatal bleeding from a lung metastasis of HCC.
一名67岁男性，双侧叶均患有不可切除的肝细胞癌（HCC）且伴有肝硬化，接受了经导管动脉栓塞和区域化疗。他情况良好地维持了18个月。因发热、胸痛和多发肺转移再次入院。在白细胞介素-2治疗期间，他突然出现呼吸困难和心悸，并陷入休克。通过引流3升新鲜血液确诊为左侧血胸。尽管进行了重症监护，他在36小时内死亡。尸检显示血胸是由左肺上叶的一个转移灶破裂所致，且原发性HCC完全坏死。文献检索未发现HCC肺转移导致致命出血的报告。
