PMC9851658_01
Frontal chest radiograph shows complete opacification of left hemithorax with significant mass effect.
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Imaging showed a large heterogenous intermediate density mass filling and expanding the left hemithorax, causing a complete collapse of the left lung and substantial right deviation of heart and mediastinum (Fig. 1).
Coronal magnetic resonance image, showing the large heterogeneous mass occupying the left hemithorax. Note severe displacement of the heart and vasculature as well as complete atelectasis of the lung (L), left ventricle (LV), right atrium (RA), aorta (A), pulmonary trunk (P).
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Magnetic resonance imaging showed no invasion of chest wall or visceral structures, consistent with resectability (Fig. 2).
(A) Conventional angiogram engaging the left inferior phrenic artery, which perfuses much of the mass. (B) Postembolization results, demonstrating marked decrease in the mass blood supply.
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To prepare for resection, thoracic aortography showed 75% of tumor arterial supply from left inferior phrenic artery, which was subsequently coiled with particles (500 mum and 700 mum embospheres) (Fig. 3A). Postembolization arteriogram demonstrated near complete cessation of anterior flow within this vessel and its branches (Fig. 3B).
Frontal chest radiograph 2 months after resection with near-complete left lung expansion.
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At 2-month follow-up visit patient reports mild discomfort during strenuous movement/heavy lifting but denies any shortness of breath (Fig. 4).