Percutaneous transcatheter aspiration of pulmonary embolism leading to diagnosis of hepatocellular carcinoma tumor embolus and change in systemic chemotherapy

IF 0.9 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Niklas Verloh, Katharina Vogt, D. Bettinger, Michael Schultheiss, Kosmas Kandilaris, Philipp A Holzner, M. Doppler, Wibke Uller
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Abstract

The management of metastatic hepatocellular carcinoma (HCC) is complex, particularly when complicated by pulmonary embolism. In these cases, atezolizumab-bevacizumab therapy is contraindicated due to an elevated risk of thromboembolic events. Differentiating pulmonary tumor embolism from thromboembolic disease is diagnostically challenging. This report outlines the benefit of transcatheter aspiration to obtain pathological evidence of pulmonary artery tumor embolus in an HCC patient. The intervention enabled a significant shift in the management strategy, leading to an escalation of systemic HCC therapy. This case underscores the importance of precise diagnostic techniques such as transcatheter aspiration in guiding treatment decisions, particularly in cases where pulmonary embolism may signify an underlying malignancy-driven process.
经皮经导管肺栓塞抽吸术诊断出肝癌肿瘤栓塞并改变全身化疗方案
转移性肝细胞癌(HCC)的治疗非常复杂,尤其是并发肺栓塞时。在这些病例中,由于血栓栓塞事件的风险升高,阿特珠单抗-贝伐单抗治疗是禁忌症。将肺部肿瘤栓塞与血栓栓塞性疾病区分开来在诊断上具有挑战性。本报告概述了经导管抽吸术为一名 HCC 患者获取肺动脉肿瘤栓塞病理证据所带来的益处。这一干预措施使治疗策略发生了重大转变,导致全身性 HCC 治疗的升级。该病例强调了经导管抽吸术等精确诊断技术在指导治疗决策方面的重要性,尤其是在肺栓塞可能意味着潜在恶性肿瘤驱动过程的病例中。
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