Pulmonary hemorrhage and hemopneumothorax following the administration of lenvatinib for lung metastasis from hepatocellular carcinoma

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 perfor...

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Main Authors: Kazuya Kishimoto, Nobuhiro Izumi, Hirotaka Kinoshita, Takuya Tanimura, Satoshi Suzuki, Kantaro Hara, Hidetoshi Inoue, Takuma Tsukioka, Masanori Shiohara, Naoshi Odagiri, Junichi Soh
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Respiratory Medicine Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213007125000693
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author Kazuya Kishimoto
Nobuhiro Izumi
Hirotaka Kinoshita
Takuya Tanimura
Satoshi Suzuki
Kantaro Hara
Hidetoshi Inoue
Takuma Tsukioka
Masanori Shiohara
Naoshi Odagiri
Junichi Soh
author_facet Kazuya Kishimoto
Nobuhiro Izumi
Hirotaka Kinoshita
Takuya Tanimura
Satoshi Suzuki
Kantaro Hara
Hidetoshi Inoue
Takuma Tsukioka
Masanori Shiohara
Naoshi Odagiri
Junichi Soh
author_sort Kazuya Kishimoto
collection DOAJ
description 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.
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institution Kabale University
issn 2213-0071
language English
publishDate 2025-01-01
publisher Elsevier
record_format Article
series Respiratory Medicine Case Reports
spelling doaj-art-e0204e68d866458dbf7f19dc2a05ab512025-08-20T03:30:15ZengElsevierRespiratory Medicine Case Reports2213-00712025-01-015610223310.1016/j.rmcr.2025.102233Pulmonary hemorrhage and hemopneumothorax following the administration of lenvatinib for lung metastasis from hepatocellular carcinomaKazuya Kishimoto0Nobuhiro Izumi1Hirotaka Kinoshita2Takuya Tanimura3Satoshi Suzuki4Kantaro Hara5Hidetoshi Inoue6Takuma Tsukioka7Masanori Shiohara8Naoshi Odagiri9Junichi Soh10Department of Thoracic Surgery, Graduate School of Medicine, Osaka Metropolitan University, Osaka, JapanDepartment of Thoracic Surgery, Graduate School of Medicine, Osaka Metropolitan University, Osaka, JapanDepartment of Thoracic Surgery, Graduate School of Medicine, Osaka Metropolitan University, Osaka, JapanDepartment of Thoracic Surgery, Graduate School of Medicine, Osaka Metropolitan University, Osaka, JapanDepartment of Thoracic Surgery, Graduate School of Medicine, Osaka Metropolitan University, Osaka, JapanDepartment of Thoracic Surgery, Graduate School of Medicine, Osaka Metropolitan University, Osaka, JapanDepartment of Thoracic Surgery, Graduate School of Medicine, Osaka Metropolitan University, Osaka, JapanDepartment of Thoracic Surgery, Graduate School of Medicine, Osaka Metropolitan University, Osaka, JapanDepartment of Pathology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, JapanDepartment of Hepatology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, JapanDepartment of Thoracic Surgery, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan; Corresponding author. Department of Thoracic Surgery, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka city, Osaka, Japan.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.http://www.sciencedirect.com/science/article/pii/S2213007125000693LenvatinibHemopneumothoraxLung metastasisHepatocellular carcinoma
spellingShingle Kazuya Kishimoto
Nobuhiro Izumi
Hirotaka Kinoshita
Takuya Tanimura
Satoshi Suzuki
Kantaro Hara
Hidetoshi Inoue
Takuma Tsukioka
Masanori Shiohara
Naoshi Odagiri
Junichi Soh
Pulmonary hemorrhage and hemopneumothorax following the administration of lenvatinib for lung metastasis from hepatocellular carcinoma
Respiratory Medicine Case Reports
Lenvatinib
Hemopneumothorax
Lung metastasis
Hepatocellular carcinoma
title Pulmonary hemorrhage and hemopneumothorax following the administration of lenvatinib for lung metastasis from hepatocellular carcinoma
title_full Pulmonary hemorrhage and hemopneumothorax following the administration of lenvatinib for lung metastasis from hepatocellular carcinoma
title_fullStr Pulmonary hemorrhage and hemopneumothorax following the administration of lenvatinib for lung metastasis from hepatocellular carcinoma
title_full_unstemmed Pulmonary hemorrhage and hemopneumothorax following the administration of lenvatinib for lung metastasis from hepatocellular carcinoma
title_short Pulmonary hemorrhage and hemopneumothorax following the administration of lenvatinib for lung metastasis from hepatocellular carcinoma
title_sort pulmonary hemorrhage and hemopneumothorax following the administration of lenvatinib for lung metastasis from hepatocellular carcinoma
topic Lenvatinib
Hemopneumothorax
Lung metastasis
Hepatocellular carcinoma
url http://www.sciencedirect.com/science/article/pii/S2213007125000693
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