Extirpation of a thrombus during pulmonary metastasectomy in a patient with chronic pulmonary thromboembolism

A 57-year-old woman with chronic pulmonary thromboembolism was diagnosed to have metastatic lung tumors 6 months after an operation performed for colon cancer. There were no respiratory symptoms associated with the pulmonary thromboembolism. Computed tomography showed 2 pulmonary masses in the right middle and lower lobes, and a thrombus in the inferior trunk of the right pulmonary artery. Excision of the 2 pulmonary metastases was performed and the thrombus in the pulmonary artery was also removed at the same time. Partial improvement of the pulmonary blood flow was observed in the postoperative pulmonary scintigram. Chronic pulmonary thromboembolism without respiratory symptoms is not usually an indication for extirpation of thrombus. However, incidental extirpation of a pulmonary thrombus at the time of other pulmonary surgery should be considered, as it may yield an improvement of the pulmonary blood flow.