Intraoperative transesophageal echocardiographic localization of tumor embolus during pneumonectomy

We describe a patient undergoing pneumonectomy for large-cell carcinoma, which at the time of surgery was found to invade the pulmonary veins. Transesophageal echocardiography was used to confirm and localize suspected tumor embolization during surgery. Although tumor embolization from the pulmonary veins has been previously reported in the literature, this is the first case, to our knowledge, of transesophageal echocardiographic documentation of such an occurrence. The use of echocardiography in patients at potential risk for tumor involvement of the pulmonary veins is discussed.