Starr D S, Lawrie G M, Morris G C
Cancer. 1981 Jan 15;47(2):398-401. doi: 10.1002/1097-0142(19810115)47:2<398::aid-cncr2820470230>3.0.co;2-r.
Although blood spread of pulmonary malignancy presumably occurs through microembolization, frank embolization of tumor fragments is uncommon. The first reported case of bronchogenic carcinoma appearing as a peripheral arterial embolus is described. The patient, a 64-year-old female, had acute ischemia of the left leg secondary to tumor embolism to the left profunda femoris and popliteal arteries. Shortly after embolectomy, she suffered atelectasis of the whole left lung from an epitheloid carcinoma in the left main bronchus. Twenty-eight cases of frank tumor embolism to the arterial tree occurring during the course of a noncardiac malignancy have been reported. None, however, occurred as an initial event. Pulmonary metastasis in patients with advanced malignancy was the source of the arterial emboli in 45% (13/29) of reported cases, but bronchogenic carcinoma was the original cell type in 38% (11/29) of cases. In general, arterial tumor embolism is a complication of advanced malignancy usually originating from one of multiple pulmonary metastases. This first case report of tumor embolism to a lower extremity occurring as the initial event in the clinical course of a bronchogenic carcinoma serves to emphasize the protein manifestations of malignant disease.
尽管肺恶性肿瘤的血行播散可能是通过微栓塞实现的，但肿瘤碎片的明显栓塞并不常见。本文描述了首例表现为外周动脉栓子的支气管源性癌病例。该患者为一名64岁女性，因左股深动脉和腘动脉的肿瘤栓塞继发左腿急性缺血。取栓术后不久，她因左主支气管的上皮样癌出现左肺全肺不张。据报道，在非心脏恶性肿瘤病程中发生的28例明显的肿瘤栓塞至动脉系统的病例中，无一例是以这种情况为首发事件。在报告的病例中，45%（13/29）的晚期恶性肿瘤患者的肺转移是动脉栓子的来源，但38%（11/29）的病例中支气管源性癌是原始细胞类型。一般来说，动脉肿瘤栓塞是晚期恶性肿瘤的一种并发症，通常起源于多个肺转移灶之一。这例作为支气管源性癌临床病程首发事件的下肢肿瘤栓塞的首例病例报告，强调了恶性疾病蛋白质方面的表现。
