Pulmonary arteriovenous fistula in a patient with renal cell carcinoma

Abstract

Arteriovenous (AV) fistulas are common in renal cell carcinoma. These are usually small and asymptomatic. Case reports have previously described symptomatic fistulas in primary renal cell tumour or, less commonly, bone metastases.The current study describes a patient with lung metastases from renal cell carcinoma who developed a symptomatic pulmonary AV fistula. The patient presented with debilitating progressive shortness of breath, which resolved after coiling of the pulmonary AV fistula. Supporting radiographs include a unique ventilation-perfusion finding of perfusion tracer in the kidney that is diagnostic of a pulmonary shunt. This is the first report of a pulmonary fistula from renal cell carcinoma. This rare complication of renal cell carcinoma reflects its diverse clinical presentations and unique tumour biology.

Diffuse large B-cell lymphoma presenting as reversible intrapulmonary arteriovenous shunts with hypoxia, fever and progressive jaundice: a case report and literature review

“…It can also be caused by a variety of acquired disease, with the pathogenesis has not been fully elucidated. It was reported that some conditions can lead to the formation of PAVFs, such as blood metastatic in the lung of choriocarcinoma and renal cell carcinoma [ 14 , 15 ]. Less common concomitant diseases include penetrating chest trauma, mitral stenosis, schistosomiasis, actinomycosis, Fanconi syndrome, and metastatic thyroid cancer [ 16 ].…”

Cerebral Embolization of Ethiodized Oil following Intranodal Lymphangiography

“…Most pulmonary AV shunts are hereditary and noted in patients with hereditary hemorrhagic telangiectasia; however, enlarged acquired shunts may also be noted in patients with hepatopulmonary syndrome, malignancy, and schistosomiasis. 17,18 In addition to its use in lymphangiography, ethiodized oil is also used as a contrast agent in hysterosalpingography and is routinely used as an embolic agent in transarterial chemoembolization (TACE), most commonly for primary liver cancer. 19 There are multiple case reports of systemic embolization of ethiodized oil after these procedures.…”

Differential kinetics of response and toxicity using stereotactic radiation and interventional radiological coiling for pulmonary arterio‐venous shunting from metastatic leiomyosarcoma

“…This is the third case report of AV shunting from pulmonary metastases . There may be an increase in such presentations, given improvements in oncological care and extended survival in patients with vascular lung metastases.…”