一例因肺多形性癌导致的脑梗死。
A case of cerebral infarction due to pleomorphic carcinoma of the lung.
作者信息
Yoshikawa Shinichiro, Kamide Tomoya, Kasakura Shigen, Arai Noriko, Osada Takashi, Mouri Atsuto, Hamada Mei, Kawasaki Tomonori, Takao Masaki, Kohyama Shinya
机构信息
Stroke Center, Department of Cerebrovascular Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan.
Stroke Center, Department of Endovascular Neurosurgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan.
出版信息
Surg Neurol Int. 2020 Aug 1;11:217. doi: 10.25259/SNI_37_2020. eCollection 2020.
BACKGROUND
With the increase in endovascular treatment, reports of embolism other than thrombus are scattered, but intracranial tumorigenic embolism is rare and difficult to diagnose. Here, we describe a case of a tumorigenic embolism in a patient with lung cancer whose invasion into the vascular system was not detected on preoperative whole-body imaging.
CASE DESCRIPTION
A 66-year-old man who was hospitalized to undergo radiotherapy for pulmonary carcinoma suddenly developed left hemiplegia. He exhibited atrial fibrillation, and emergent radiographic examination revealed a right middle cerebral artery occlusion. Urgent mechanical embolectomy was performed, with successful revascularization. The excised embolus had a unique morphology and was pathologically diagnosed as a cerebral embolism caused by pleomorphic pulmonary carcinoma.
CONCLUSION
Tumor-derived cerebral embolism is extremely rare, but it is necessary to consider it as a potential source of embolism during differential diagnosis in patients with malignant tumors.
背景
随着血管内治疗的增加，除血栓外的栓塞报告较为零散，但颅内肿瘤源性栓塞罕见且难以诊断。在此，我们描述一例肺癌患者发生肿瘤源性栓塞的病例，其术前全身成像未检测到肿瘤侵犯血管系统。
病例描述
一名66岁男性因肺癌住院接受放疗，突然出现左侧偏瘫。他患有心房颤动，紧急影像学检查显示右侧大脑中动脉闭塞。紧急进行了机械取栓术，血管再通成功。切除的栓子具有独特的形态，经病理诊断为多形性肺癌引起的脑栓塞。
结论
肿瘤源性脑栓塞极为罕见，但在恶性肿瘤患者的鉴别诊断中，有必要将其视为潜在的栓塞来源。
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