Spontaneous showering of tumor emboli in a patient with advanced primary lung cancer: a case report

Schreffler, Susan M.; Paolo, William F.; Kloss, Brian T.

doi:10.1186/1865-1380-5-27

Cited by 24 publications

(25 citation statements)

References 13 publications

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“…Most of them are associated with primary or secondary pulmonary malignancies, which occurred during intraoperative and postoperative periods. Only 11 cases of histologically proven primary pulmonary malignancies have been reported, in which spontaneous arterial tumor embolism caused sudden onset of symptoms . Among them, tumor emboli were seen in common femoral artery in four cases; in multiple arteries further from aorta in two cases; and in coronary artery, iliac artery, posterior cerebral artery, left cerebral artery and profunda femoris artery, and visceral artery in one case each.…”

Section: Discussionmentioning

confidence: 99%

Massive tumor embolism in the abdominal aorta from pulmonary squamous cell carcinoma: Case report and review of the literature

Ohshima

Tsujii

Sakai

et al. 2017

Pathology International

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Acute arterial tumor embolism is a rare complication in cancer patients. Most of the previously reported cases of arterial tumor embolism have been associated with pulmonary malignancies and occurred during the intraoperative and postoperative periods. Very few cases occurred spontaneously. To our knowledge, there is no previous report of spontaneous and massive tumor embolism occluding the abdominal aorta in patients suffering from primary pulmonary carcinoma. We describe the case of 64-year-old man who presented with left homonymous hemianopsia and backache. Further evaluation revealed a mass in the right lung, severe coagulopathy, and cerebral hemorrhagic infarction in the right occipital lobe. He suddenly developed lower limb ischemia 4 weeks after his first clinical visit, and finally, died of multiple organ failure. Autopsy showed non-keratinizing squamous cell carcinoma in the right lung and massive tumor emboli in the abdominal aorta containing nests of squamous cell carcinoma. Infarct regions were found in the bilateral kidneys, spleen, liver, and brain; fibrin thrombi, but not tumor emboli, were found in these regions. This case suggested that tumor embolism should be considered when patients suffering from primary pulmonary malignancies develop arterial embolism and arterial tumor emboli could be massive enough to occlude the abdominal aorta.

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Section: Discussionmentioning

confidence: 99%

Massive tumor embolism in the abdominal aorta from pulmonary squamous cell carcinoma: Case report and review of the literature

Ohshima

Tsujii

Sakai

et al. 2017

Pathology International

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“…Schreffler et al reported a case of simultaneous acute bilateral lower limb ischemia, and bilateral renal, splenic, and cerebral infarction as a result of multiple emboli originating from a primary lung malignancy invasion of the left atrium. 9 Considering the risk of systemic embolization, mitral obstruction, or sudden death as a result of tumor thrombus shedding, to ensure the complete resection of tumor thrombus, comprehensive preoperative preparation and meticulous intraoperative surgery need to be particularly emphasized. Preoperative echocardiography, CT pulmonary angiography, as well as cardiac dynamic magnetic resonance and intraoperative transesophageal echocardiography should be performed whenever possible.…”

Section: Discussionmentioning

confidence: 99%

Video‐assisted thoracoscopic surgery in the treatment of non‐small‐cell lung cancer complicated with left atrial tumor thrombus

et al. 2015

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We report a case of pulmonary squamous cell carcinoma complicated with a tumor thrombus in the left atrium. The left atrial tumor thrombus, together with the left lower lobe, was removed via complete video‐assisted thoracoscopic surgery (VATS), with cardiopulmonary bypass standby. The patient recovered well from surgery, received four cycles of postoperative chemotherapy, and is now under follow‐up at the outpatient clinic. Although the optimal treatment is still controversial, simultaneous VATS and atriotomy under the premise of preoperative evaluation of the thrombus, including size and extent, might prevent systemic embolization and sudden death, alleviate the wound, promote postoperative rehabilitation, and improve prognosis in selected patients.

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“…If left untreated, patients may die from sudden cardiac arrest due to cardia inflow obstruction or massive tumor embolization in the major organs [5] [6], which is one of the most serious complications. Schreffler et al reported a case of simultaneous acute bilateral lower limb ischemia, and bilateral renal, splenic, and cerebral infarction as a result of multiple emboli originating from invasion of a primary lung malignancy in the left atrium [7]. Given the risk of systemic embolization, mitral obstruction, or sudden death as a result of tumor thrombus detachment, comprehensive preoperative preparation and meticulous intraoperative surgery need to be emphasized to ensure complete resection of the tumor thrombus.…”

Section: Discussionmentioning

confidence: 99%

Resection of Lung Cancer with Left Atrium Extension via the Pulmonary Vein: Case Report

Mizuguchi¹,

Izumi²,

Komatsu³

et al. 2018

OJTS

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A 49-year-old man had an abnormal shadow on chest X-ray. Enhanced chest computed tomography (CT) revealed an 8-cm diameter right lung mass invading the right chest wall, with a tumor thrombus extending from the superior pulmonary vein into the left atrium. Transesophageal echocardiography confirmed that the tumor adjoined the side wall of the atrium. Endobronchial and CT-guided needle biopsy demonstrated a low-grade carcinoma or small cell carcinoma. Operative findings through left atriotomy under cardiopulmonary bypass showed no tumor invasion of the atrium wall, but protrusion through the pulmonary vein. Frozen sections revealed a non-small cell carcinoma. We performed right upper lobectomy with parietal pleura and mediastinal lymph node dissection after detachment of cardiopulmonary bypass. Pathological examination demonstrated a large-cell neuroendocrine carcinoma p-T4N0M0, stage IIIA. The patient recovered without postoperative complications and tolerated two cycles of adjuvant chemotherapy. He was doing well without symptoms of recurrence 42 months after surgery.

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Spontaneous showering of tumor emboli in a patient with advanced primary lung cancer: a case report

Cited by 24 publications

References 13 publications

Massive tumor embolism in the abdominal aorta from pulmonary squamous cell carcinoma: Case report and review of the literature

Massive tumor embolism in the abdominal aorta from pulmonary squamous cell carcinoma: Case report and review of the literature

Video‐assisted thoracoscopic surgery in the treatment of non‐small‐cell lung cancer complicated with left atrial tumor thrombus

Resection of Lung Cancer with Left Atrium Extension via the Pulmonary Vein: Case Report

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