Ito K, Sageshima M, Notsu T, Araki T, Hara H, Mori T
Nihon Geka Gakkai Zasshi. 1985 Mar;86(3):357-61.
A 74-year-old female patient with a past history of the locally recurrent tumor of the liposarcoma in the right thigh over 20 years ago received an emergency vascular operation to relieve severe ischemic symptoms in the left leg. The left femoral artery was pulseless and was filled with several long, translucent and cord-like tumors which resembled the hands of a cuttlefish. The tumors were easily removed except its root adhering to the left common iliac artery. A crossover femoro-femoral artery bypass was carried out. On the 24th postoperative day she died suddenly. The autopsy findings were as follows: A hen egg-sized tumor occupied almost whole space of the left atrium, and connected with the metastatic right lung tumor via the pulmonary vein. The sudden death was probably due to the abrupt obstruction of the mitral valve by the tumor in the left atrium. The residual tumor was noted in the left common iliac artery, but its adventitia was not involved. The pathohistological diagnosis of each tumor was same, well differentiated liposarcoma. The tumors which occluded the left iliofemoral artery must have originated from the tumor in the left atrium in form of the tumor embolism, lodged in the left common iliac artery, grown intraluminally into external iliac and femoral artery, and finally caused ischemia of the left leg.
一名74岁女性患者，20多年前曾有右大腿脂肪肉瘤局部复发史，此次因左腿严重缺血症状接受了急诊血管手术。左股动脉无搏动，腔内充满数个长条形、半透明、索状肿物，类似乌贼的触手。肿物很容易被切除，只是其根部附着于左髂总动脉。进行了股-股交叉动脉搭桥术。术后第24天，患者突然死亡。尸检结果如下：一个鸡蛋大小的肿瘤几乎占据了左心房的整个空间，并通过肺静脉与右肺转移瘤相连。猝死可能是由于左心房肿瘤突然阻塞二尖瓣所致。左髂总动脉可见残留肿瘤，但其外膜未受累。各肿瘤的病理组织学诊断均为高分化脂肪肉瘤。阻塞左髂股动脉的肿瘤肯定是源于左心房肿瘤，以肿瘤栓子的形式，栓塞于左髂总动脉，在管腔内生长至髂外动脉和股动脉，最终导致左腿缺血。
