Masumoto A, Motomura K, Uchimura K, Morotomi I, Morita K
Department of Internal Medicine, National Fukuoka Higashi Hospital, Koga, Japan.
J Gastroenterol Hepatol. 1997 Feb;12(2):156-8. doi: 10.1111/j.1440-1746.1997.tb00399.x.
A 64-year-old man was admitted to our hospital with multiple hepatocellular carcinoma (HCC) lesions in the liver and lung. On the seventh hospital day, a chest radiograph showed a marked increase in right pleural effusion. A thoracentesis revealed a haemothorax. Despite repeated pleural taps and blood transfusions, the patient's clinical status worsened and he developed severe dyspnoea. An inferior phrenic arteriography on the 19th hospital day showed a tumour growing over the diaphragm into the right thoracic cavity, suggesting a tumour rupture. A transcatheter arterial embolization (TAE) of the inferior phrenic artery successfully controlled the bleeding and improved the haemothorax. There was no rebleeding; however, the patient died of advanced HCC 3 months later. To our knowledge, this is the first case of a haemothorax secondary to a ruptured HCC that was treated successfully with TAE.
一名64岁男性因肝脏和肺部多发肝细胞癌(HCC)病灶入住我院。入院第7天,胸部X线片显示右侧胸腔积液明显增加。胸腔穿刺抽出了血胸。尽管反复进行胸腔穿刺抽液和输血,但患者的临床状况仍恶化,并出现了严重呼吸困难。入院第19天的膈下动脉造影显示肿瘤越过膈肌生长至右侧胸腔,提示肿瘤破裂。膈下动脉经导管动脉栓塞术(TAE)成功控制了出血并改善了血胸情况。未再出血;然而,患者3个月后死于晚期肝癌。据我们所知,这是首例经TAE成功治疗的肝癌破裂继发血胸病例。