Karlsberg R P, Sagel S S, Ferguson T B
Chest. 1978 Nov;74(5):582-4. doi: 10.1378/chest.74.5.582.
A fatal case of massive systemic tumor embolization, with involvement of the coronary arteries, which occurred following resection of a metastatic pulmonary fibroliposarcoma, is presented. Elevation of the cardiac specific creatine kinase isoenzyme (MB-CK) documented myocardial damage due to obstruction of the coronary arteries by tumor emboli. The preoperative computed tomography scan demonstrated contiguity between the pulmonary mass, the inferior pulmonary vein and left atrium. In future cases this finding should alert the surgeon that cardiopulmonary bypass and removal of the left artial extension of the tumor under direct vision may be required to prevent embolization during pulmonary resection.
本文报告了一例致命的全身性肿瘤大量栓塞病例，累及冠状动脉，该病例发生在转移性肺纤维脂肪肉瘤切除术后。心脏特异性肌酸激酶同工酶（MB-CK）升高证明了肿瘤栓子阻塞冠状动脉导致心肌损伤。术前计算机断层扫描显示肺部肿块、肺下静脉和左心房之间相邻。在未来的病例中，这一发现应提醒外科医生，可能需要进行体外循环并在直视下切除肿瘤的左心房延伸部分，以防止肺切除术中发生栓塞。
