Department of General and Vascular Surgery, University of Medical Sciences, Poznań, Poland.
Med Sci Monit. 2009 Oct;15(10):CS155-157.
Although the majority of arterial emboli are thrombi originating from the heart, emboli of other origin do occur. The purpose of this paper is to report a case of tumor embolus of a brachial artery.
A 64-year-old woman was referred for vascular surgery due to acute right upper-limb ischemia. ECG showed sinus rhythm without ischemic changes. Four years earlier the patient had undergone total hysterectomy with bilateral adnexotomy for endometrial adenocarcinoma with subsequent radiotherapy. Emergency embolectomy under local anesthesia was performed with uneventful recovery. Because of an atypical appearance resembling fatty tissue, the embolic material was sent for microscopic examination that revealed carcinoma cells. Chest X-ray and CT-guided biopsy showed previously unknown pulmonary metastasis. In spite of chemotherapy, the patient died one year later due to progression of the neoplastic disease. The literature and common features of tumor embolus are reviewed. This may be the first reported case of tumor peripheral arterial embolus caused by endometrial adenocarcinoma
Although tumor emboli are a rarely described cause of acute limb ischemia, pathological examination of the embolic material seems to be indicated, especially in patients with an unknown source of emboli and in every case of an atypical appearance.
尽管大多数动脉栓塞是源自心脏的血栓，但也确实会发生其他来源的栓塞。本文旨在报告一例肱动脉肿瘤栓子的病例。
一名 64 岁女性因急性右上肢缺血被转介至血管外科。心电图显示窦性节律，无缺血改变。四年前，该患者因子宫内膜腺癌行全子宫切除术和双侧附件切除术，随后行放疗。在局部麻醉下进行紧急取栓术，恢复顺利。由于栓塞物质的外观类似脂肪组织，表现不典型，因此将其送检进行显微镜检查，结果显示为癌细胞。胸部 X 线和 CT 引导下的活检显示出先前未知的肺转移。尽管进行了化疗，但一年后由于肿瘤疾病的进展，患者死亡。本文回顾了文献和肿瘤栓子的常见特征。这可能是首例由子宫内膜腺癌引起的肿瘤外周动脉栓塞病例。
尽管肿瘤栓子是急性肢体缺血的罕见病因，但对栓塞物质进行病理检查似乎是必要的，尤其是在栓塞源不明的患者和在任何表现不典型的情况下。
