机械取栓治疗肿瘤栓塞所致急性大脑中动脉闭塞：1例报告
Mechanical Thrombectomy for Acute Middle Cerebral Artery Occlusion Caused by Tumor Embolism: A Case Report.
作者信息
Moriyama Takuya, Sugiura Yuri, Hayashi Yuto, Kinoshita Fukuaki, Yamamura Ryohei, Moriya Masayuki, Tatsumi Chikao, Nagatsuka Kazuyuki, Ishihara Masahiro, Nishio Masami, Tamura Hiromi, Adachi Shiro, Akazawa Yuki
机构信息
Department of Neurology, Toyonaka Municipal Hospital, Toyonaka, Osaka, Japan.
Department of Neurosurgery, Toyonaka Municipal Hospital, Toyonaka, Osaka, Japan.
出版信息
J Neuroendovasc Ther. 2021;15(1):52-57. doi: 10.5797/jnet.cr.2020-0022. Epub 2020 Sep 7.
OBJECTIVE
We report a case of acute middle cerebral artery (MCA) occlusion caused by tumor embolism.
CASE PRESENTATION
A 64-year-old man with lung cancer presented with sudden onset left-sided hemiparesis and sensory disturbance. Diffusion-weighted imaging (DWI) revealed hyper-intense foci in the right MCA territory and magnetic resonance angiography (MRA) demonstrated right MCA M2 segment occlusion. Mechanical thrombectomy (MT) was performed with Thrombolysis in Cerebral Infarction 2B recanalization. On histopathology, thrombus composed of fibrin and squamous cell carcinoma was observed. We diagnosed him with tumor embolism from lung cancer that invaded the pulmonary vein and the left atrium.
CONCLUSION
Tumor cells may be confirmed by pathological examination regardless of the morphology of the embolus. Pathological examination of the cerebral embolus is useful for the accurate diagnosis of ischemic stroke subtypes.
目的
我们报告一例由肿瘤栓塞引起的急性大脑中动脉（MCA）闭塞病例。
病例介绍
一名64岁肺癌男性突发左侧偏瘫和感觉障碍。弥散加权成像（DWI）显示右侧MCA区域有高信号灶，磁共振血管造影（MRA）显示右侧MCA M2段闭塞。采用脑梗死溶栓2B级再通进行机械取栓术（MT）。组织病理学检查发现由纤维蛋白和鳞状细胞癌组成的血栓。我们诊断他为肺癌肿瘤栓塞，肿瘤侵犯了肺静脉和左心房。
结论
无论栓子形态如何，均可通过病理检查确诊肿瘤细胞。对脑栓子进行病理检查有助于准确诊断缺血性卒中亚型。
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