Malignant arterial tumor embolization

Abstract

Malignant arterial tumor emboli large enough to cause ischemia or organ infarction are a rare, but often fatal, complication of neoplastic disease. The majority of arterial emboli are associated with primary or secondary pulmonary malignancies. The sites where they impact are similar in distribution to arteriosclerotic emboli, and the treatment follows well-established principles developed for the treatment of arteriosclerotic emboli. The results of embolectomy in accessible sites are very good, thus treatment should always be attempted. A case of a superior mesenteric tumor embolus occurring after pneumonectomy is reported, together with a review of all published cases of arterial tumor emboli of sufficient size to cause organ infarction or ischemia.

Systemic Tumor Embolism Mimicking Gefitinib ('IRESSA')-induced Interstitial Lung Disease in a Patient with Lung Cancer

“…To the best of our knowledge, fewer than 70 cases of non-myxomatous tumor emboli have been reported. The majority of non-myxomatous tumor emboli are presumed to originate from pulmonary neoplasms (9)(10)(11)(12)(13)(14)(15), and tumor emboli originating from lung cancer in cerebral, coronary and mesenteric circulation, aorta, and extremity vessels have been previously reported (17). It is considered likely that lung cancer cells erode and partially occlude one or more of the pulmonary veins, and tumor cells are ejected into the systemic circulation after tumor mass fractures.…”

A Rare Clinical Entity of Lung Cancer: Metastatic Peripheral Arterial Embolism

“…The most frequently reported sites of tumor emboli are aortic bifurcation, femoral vessels, and cerebral arteries (2). Nearly 200 cases of arterial embolism have been reported in the literature from malignant tumor tissue (3,6). Intravenous digital angiography, contrast enhanced computerized tomography, MRI, and echocardiography are the diagnostic methods.…”

Brainstem Infarction due to a Tumor Embolus

“…We cannot rule out such a mechanism in our patient, although the clinical circumstances of his brainstem infarction remain typical of tumor embolus in the absence of other underlying risk factors for embolic complications. To date, only 60 cases of arterial tumor embolism are reported [3], of whom only 18 involved the brain and only 2 affected the brainstem. In 4 cases, the tumor was of germ cell origin.…”

“…The sudden onset of a neurological deficit in the setting of lung surgery and tumor resection is highly suggestive of tumor embolism. Massive arterial tumor embolism often occurs peri- operatively following resection of primary or secondary malignancies of the lung [3,6]. Presumably, a tumor mass that has penetrated a pulmonary vein is released into the bloodstream as a result of surgical manipulations during lung resection.…”

“…Indeed, massive arterial tumor embolism is a very rare event [2.3], typically described in atrial myx omas and primary or secondary lung tumors. Embolization of tumor is usually to the aorta and limbs [3], and brain infarction is secondary to involvement of the carotid artery domain. To date, there are only two reported cases of tumor embolism in the vertebrobasilar territory [4,5].…”