BUDD−CHIARI SYNDROME IN A PATIENT WITH SMALL CELL LUNG CANCER: A CASE REPORT

  • Marko Bjelakovic Clinic of pulmology, Clinical Centre Nis
  • Milan Radović University of Niš, Faculty of Medicine, Niš, Serbia; University Clinical Cetner Niš, Clinic of Pulmology, Niš, Serbia
  • Zoran Stamenković University Clinical Center of Niš, Clinic of pulmology, Niš, Serbia
  • Milica Bjelaković Univeristy Clinical Center Niš, Clinic of Gastroenterology, Niš, Serbia
  • Kristina Jović University Clinical Center of Niš, Clinic of pulmology, Niš, Serbia
Keywords: Budd−Chiari syndrome, lung cancer

Abstract


Budd−Chiari syndrome (BCS) is a rare disease caused by hepatic venous outflow tract obstruction which can occur anywhere along the path from the hepatic venules to the inferior vena cava inflow into the right ventricle. Liver congestion results in hypoxic damage of hepatocytes. Etiologic factors related to BCS are hematologic and malignant disease. Budd−Chiari syndrome is a rare condition in lung cancer patients. Only a few cases have been reported during the last decades. We present a very rare case of acute BCS syndrome in a patient with primary small cell lung cancer caused by tumor thrombus of the inferior vena cava. The diagnosis was made based on ultrasound findings. Thereafter treatment with anticoagulant therapy was started. Due to the poor performance status and significant liver damage, specific oncological treatment with chemotherapy was not started. The patient was discharged from the hospital and advised to continue symptomatic therapy. Pulmonologists should be aware that BCS syndrome could be a presenting feature of an unrecognized lung cancer.

References

Barbosa-Martins J, Costa A, Costa M, Formigo M, Cotter J. Metastatic lung cancer with multiorgan thrombosis and Budd-Chiari syndrome: a rare case. Eur J Case Rep Intern Med 2022;9(7):003386. [CrossRef] [PubMed]

Budd G. On diseases of the liver. Philadelphia: Lea and Blanchard; 1846. [CrossRef]

Chiari H. Ueber die selbständige Phlebitis obliterans der Hauptstämme der Venae hepaticae als Todesursache. Beiträge zur Pathologie 1976;158(1):31-41. [CrossRef]

Darwish Murad S, Plessier A, Hernandez-Guerra M, Fabris F, Eapen CE, Bahr MJ, et al. Etiology, management, and outcome of the Budd-Chiari syndrome. Ann Intern Med 2009;151(3):167-75. [CrossRef] [PubMed]

Demura Y SK, Nakanishi M, Ameshima S, Ishizaki T, Miyamori I. Case of small cell carcinoma causing Budd-Chiari syndrome by tumor thrombus of the inferior vena cava. Japanese Journal of Lung Cancer 1998;38(2):159-65. [CrossRef]

Dhali A, Biswas DN, Parvin S, Ray S, Ghosh R. Transdiaphragmatic spread of lung cancer: A rare cause of Budd--Chiari syndrome. Indian J Pathol Microbiol 2022;65(3):722-3. [CrossRef] [PubMed]

EASL Clinical Practice Guidelines: Vascular diseases of the liver. J Hepatol 2016;64(1):179-202. [CrossRef] [PubMed]

Fujita K, Kim YH, Yoshino M, Ichikawa M, Mio T, Mishima M. Acute Budd–Chiari syndrome caused by tumor thrombus of the inferior vena cava secondary to non-small cell lung cancer. Respiratory Medicine CME 2010;3(1):26-8. [CrossRef]

Garcia-Pagán JC, Valla DC. Primary Budd-Chiari Syndrome. N Engl J Med 2023;388(14):1307-16. [CrossRef] [PubMed]

Hernández-Gea V, De Gottardi A, Leebeek FWG, Rautou PE, Salem R, Garcia-Pagan JC. Current knowledge in pathophysiology and management of Budd-Chiari syndrome and non-cirrhotic non-tumoral splanchnic vein thrombosis. J Hepatol 2019;71(1):175-99. [CrossRef] [PubMed]

Huang YW, Yang JC, Chang YL, Tsang YM, Wang TH. Acute pancreatitis combined with acute Budd-Chiari syndrome as the initial manifestation of small cell lung cancer. J Formos Med Assoc 2005;104(6):431-5. [PubMed]

Iliescu L, Toma L, Mercan-Stanciu A, Grumeza M, Dodot M, Isac T, et al. Budd-Chiari syndrome - various etiologies and imagistic findings. A pictorial review 2019;21(3):5. [CrossRef] [PubMed]

Janssen HLA, Garcia-Pagan J-C, Elias E, Mentha G, Hadengue A, Valla D-C. Budd–Chiari syndrome: a review by an expert panel. Journal of Hepatology 2003;38(3):364-71. [CrossRef] [PubMed]

Khan F, Armstrong MJ, Mehrzad H, Chen F, Neil D, Brown R, et al. Review article: a multidisciplinary approach to the diagnosis and management of Budd-Chiari syndrome. Aliment Pharmacol Ther 2019;49(7):840-63. [CrossRef] [PubMed]

Menon KV, Shah V, Kamath PS. The Budd-Chiari syndrome. N Engl J Med 2004;350(6):578-85. [CrossRef] [PubMed]

Ough YD, Pitchumoni CS, Davidian MM, Thelmo WL. Budd-Chiari syndrome complicating bronchogenic carcinoma. N Y State J Med 1981;81(1):73-5.

Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021;71(3):209-49. [CrossRef] [PubMed]

Valla DC. Budd-Chiari syndrome/hepatic venous outflow tract obstruction. Hepatol Int 2018;12(Suppl 1):168-80. [CrossRef] [PubMed]

Valla DC. The diagnosis and management of the Budd-Chiari syndrome: consensus and controversies. Hepatology 2003;38(4):793-803. [CrossRef] [PubMed]

Published
2025/02/07
Section
Case report