Acute Ischemic Stroke due to Undifferentiated Sarcoma: A Case Report and Literature Review

Abstract

Tumor emboli due to a sarcoma are usually confirmed by an autopsy or operative findings. A sarcoma embolus in an acute stroke patient is rare. We herein report a 37-year-old man with acute stroke caused by internal carotid artery occlusion who underwent embolectomy. A histopathological analysis of an embolus obtained with a mechanical retriever device was diagnosed as undifferentiated sarcoma. This is the first case of extracardiac sarcoma extraction via mechanical retrieval performed during intervention for acute ischemic stroke. A histopathologic evaluation with embolectomy is important for diagnosing tumor emboli.

White Embolus-induced Basilar Artery Occlusion Due to Pulmonary Vein Invasion of a Metastasis of a Malignant Melanoma

“…The causes of tumor embolism are classified as cardiac tumors, such as left atrial myxoma, and noncardiac tumors. The causes of noncardiac tumor embolism include aortic invasion, pulmonary vein invasion, and embolism via a right-to-left shunt (7)(8)(9). In the present case, aortic invasion was not observed on contrast-enhanced CT, and a right-to-left shunt was not detected on transthoracic echocardiography.…”

Tumor embolism and acute arterial occlusion: A systematic review

“…Discharged. Morbidity: major surgery Walong et al [ 26 ] Cardiac Myxoma Cerebral circulation (stroke) Death Matthew et al [ 27 ] Cardiac Myxoma Infra-renal aorta (bilateral lower limb ischemia) Embolectomy Surgical excision Discharged Gudipalli et al [ 28 ] Signet cell carcinoma (GI tract origin) Bony metastases DIC and haematuria, Digital infarction Death Salam et al [ 29 ] Urothelial carcinoma Lung metastases involving pulmonary arteries and veins Pulmonary artery (pulmonary hypertension) Diagnostic VATS wedge Death Khreis et al [ 30 ] Squamous cell lung cancer Invasion into pulmonary vein and left atrium Right renal artery (infarct) Discharged for palliative chemo Latifi et al [ 31 ] Atrial myxoma Splenic infarct Renal infarcts Right external and internal iliac artery, Left common femoral artery, coronary artery Bilateral femoral embolectomy Surgical excision Discharged Goddard et al [ 32 ] Neuroendocrine lung cancer Invasion into pulmonary vein Basilar artery (stroke) Endovascular embolectomy Death Carnevale et al [ 33 ] Acute myeloid leukemia Femoral artery Tibial artery Femoral embolectomy, common femoral endarterectomy, and patch plasty and tibial embolectomy Discharged Fukami et al [ 34 ] Sarcoma Internal carotid artery (stroke) Percutaneous embolectomy Discharged Ali et al [ 35 ] Atrial Myxoma Coronary artery (Myocardial infarction) Thrombolysis,...…”

Delayed emergence from anesthesia caused by an intraoperative cerebral embolism of a malignant peripheral nerve sheath tumor in a neurofibromatosis type 1 patient: a case report

“…Cerebral artery tumor embolism induces acute neurological disorder; however, it is rarely diagnosed because of its low incidence and necessity of histological confirmation [ 12 , 13 ]. There is one published review of histological diagnoses of 14 cases which had undergone endovascular mechanical embolectomy for tumors causing acute cerebral ischemic stroke [ 14 ]. According to the review, only two of 14 were diagnosed with sarcoma [ 14 ].…”

“…There is one published review of histological diagnoses of 14 cases which had undergone endovascular mechanical embolectomy for tumors causing acute cerebral ischemic stroke [ 14 ]. According to the review, only two of 14 were diagnosed with sarcoma [ 14 ]. In our case, the emboli were histologically uncommon because MPNST is a sarcoma that accounts for only 2–4% of all soft tissue sarcomas [ 15 ].…”