Figure 1 Preoperative evaluation and intraoperative findings of a patient with endobronchial metastasis from hepatocellular carcinoma. (A) March 2025 PET-CT Findings: Right hilar mass, dimensions: 3.1×2.8 cm; FDG-avid lesion (SUVmax 10.3), obstructive pneumonitis in right upper lobe. The highlighted hyperintense regions (orange) demonstrate the tumor. (B) Bronchoscopy identified complete tumor occlusion at the right upper lobe bronchus ostium. (C) June 2025 follow-up imaging: contrast-enhanced chest CT demonstrated progressive disease with interval enlargement of the right hilar mass to 6.1 cm maximal diameter (3 weeks after neoadjuvant therapy initiation). (D) Green solid line: outlines the anatomical contour of the SVC, clearly illustrating its relationship to the tumor. The red circle indicates the most prominent site of SVC invasion by the tumor, representing a critical surgical challenge for vascular dissection and preservation. Black dashed line: denotes the pericardial incision, exposing the intrapericardial root of the SVC. Yellow contour: highlights the use of a suction device to retract the SVC, revealing the underlying main trunk of the right pulmonary artery and demonstrating the difficulty in dissecting the proximal pulmonary artery. PET – positron emission tomography; CT – computed tomography; FDG – fluorodeoxyglucose; SUVmax – standardized uptake value-maximum; SVC – superior vena cava.