卵圆孔未闭在神经内分泌前列腺癌诱导的肝肺综合征中的作用

Q4 Medicine

JACC. Case reports Pub Date : 2025-10-01 DOI:10.1016/j.jaccas.2025.105217

Zoee U. D'Costa MD , Nida Qadir MD , Rushi V. Parikh MD , Jamil A. Aboulhosn MD , Angela Li MD , John Shen MD , Irene Riahi MD , Alison Xiaotang Du MD, MSc , Eric H. Yang MD

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引用次数: 0

摘要

背景：肝肺综合征（HPS）是晚期肝病继发低氧血症的原因之一。神经内分泌前列腺癌（NEPC）是一种罕见的恶性肿瘤，预后差。病例总结：这是一例由NEPC引起的HPS低氧血症，由先前不明显的卵圆孔未闭（PFO）引起的右至左分流加重。PFO关闭导致症状短暂缓解，但由于没有早期确认NEPC诊断，患者最终死亡。文献中很少有病例讨论继发于恶性肿瘤的HPS，迄今为止也没有关于NEPC引起HPS的病例。本病例强调了早期识别NEPC的重要性，临床诊断策略，以及对HPS病例PFO关闭干预的讨论。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Patent Foramen Ovale Closure in Neuroendocrine Prostate Cancer–Induced Hepatopulmonary Syndrome

Background

Hepatopulmonary syndrome (HPS) is a cause of hypoxemia secondary to advanced liver disease. Neuroendocrine prostate cancer (NEPC) is a rare but highly aggressive cancer with poor prognosis.

Case Summary

This is a unique case of hypoxemia from HPS induced by NEPC, exacerbated by right-to-left shunting from a previously insignificant patent foramen ovale (PFO). PFO closure yielded brief resolution of symptoms, but without early confirmation of NEPC diagnosis, the patient ultimately died.

Discussion

There are few cases in the literature that discuss HPS secondary to malignancy and none to date about NEPC causing HPS. This case highlights the importance of early identification of NEPC, clinical diagnosis strategy, and discussion of intervention of PFO closure in cases of HPS.

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