Fujiwara Yuta, Hayashi Kentaro, Shibata Yohei, Furuta Tatsuya, Yamasaki Tomohiro, Yamamoto Kazuhiro, Uchimura Masahiro, Nakagawa Fumio, Kambara Mizuki, Nagai Hidemasa, Akiyama Yasuhiko
1Department of Neurosurgery, Shimane University Hospital, Izumo, Shimane, Japan; and.
2Advanced Stroke Center, Shimane University Hospital, Izumo, Shimane, Japan.
J Neurosurg Case Lessons. 2023 Jan 30;5(5). doi: 10.3171/CASE22293.
Development in mechanical thrombectomy is progressing dramatically. Tumor embolism has been rarely reported on the basis of pathological study of the retrieved thrombus. Herein, the authors report a case of cerebral tumor embolism from advanced thyroid cancer, which was successfully treated with mechanical thrombectomy.
A 57-year-old man was diagnosed with thyroid cancer with multiple lung metastases and chemotherapy was planned. He experienced left hemiparesis and was bought to the emergency section of the authors' hospital. Magnetic resonance angiography revealed right internal carotid artery occlusion and endovascular treatment was performed. Using a combination of aspiration catheter and stent retriever, white jelly-like embolus was retrieved. The pathological study demonstrated thyroid cancer embolism. Pulmonary vein invasion following lung metastasis of thyroid cancer was most presumably the cause of the tumor embolism.
Lung metastasis invading the pulmonary vein may be a cause of tumor embolism. Mechanical thrombectomy using a combination of stent retriever and aspiration catheter is effective in removing the tumor embolus and the pathological examination of the embolus is essential.
机械取栓术的发展日新月异。基于对取出血栓的病理研究，肿瘤栓塞鲜有报道。在此，作者报告一例晚期甲状腺癌导致的脑肿瘤栓塞病例，该病例通过机械取栓术成功治愈。
一名57岁男性被诊断为甲状腺癌伴多发肺转移，计划进行化疗。他出现左侧偏瘫，被送至作者所在医院的急诊科。磁共振血管造影显示右侧颈内动脉闭塞，并进行了血管内治疗。使用抽吸导管和支架取栓器联合，取出了白色果冻样栓子。病理研究证实为甲状腺癌栓塞。甲状腺癌肺转移后侵犯肺静脉很可能是肿瘤栓塞的原因。
侵犯肺静脉的肺转移可能是肿瘤栓塞的一个原因。使用支架取栓器和抽吸导管联合进行机械取栓术对于清除肿瘤栓子有效，且对栓子进行病理检查至关重要。
