Endothoracic lymphatic plexus­hemiazygos vein anastomosis for chylothorax complicated with hepatocellular carcinoma: A case report.

ABSTRACT

For patients with hepatocellular carcinoma and cirrhosis, the rupture of thin lymphatic vessel walls leads to a profuse outflow of lymph fluid. Typically, chyloperitoneum tends to precede the development of chylothorax in patients with cancer. The present study describes the case of a male patient with hepatocellular carcinoma who developed chylothorax without chyloperitoneum. Computed tomography showed lymphatic system developmental abnormalities with a large volume of leaked lymph fluid. Multiple thoracic duct ligations (TDLs) failed, but a side-to-end lymphatic venous anastomosis (LVA) surgery resolved the symptoms. To the best of our knowledge, there are no reports of chylothorax occurrence after cirrhosis further complicated by congenital lymphatic abnormalities in the English-language literature. In conclusion, LVA could be appropriate to treat chylothorax when TDL is ineffective as a remedial or even prophylactic intervention.