A Case of Mechanical Reperfusion Therapy for Cerebral Infarction Induced by Tumor Embolism from Lung Cancer

Tsurusaki, Yuichiro; Takahara, Kenta; Koga, Noriyuki; Amano, Toshiyuki; Haga, Sei; Arihiro, Shoji

doi:10.5797/jnet.cr.2018-0138

Cited by 10 publications

(11 citation statements)

References 18 publications

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“…The thrombi retrieved from the four patients with cerebral embolization due to extracardiac tumors shown in Table 1 were white and hard, and had different morphological characteristics from usual thormbi. 1,10,11,14) However, the appearance and elasticity of the embolus in our patient did not differ from those of usual thrombi. We initially considered the etiology of infarction to be cardiogenic cerebral embolism because of the history of paroxysmal atrial condition was complicated by paroxysmal atrial fibrillation, dabigatran was administrated.…”

Section: Case Presentationcontrasting

confidence: 55%

“…The 15 cases that have been reported are shown in Table 1. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] Cerebral embolism due to extracardiac tumor is considered to be caused by vascular infiltration of the tumor. In the present case, the tumor infiltrated the pulmonary vein and left atrium.…”

Section: Discussionmentioning

confidence: 99%

“…Of the 15 reported cases of tumor embolism, 4 had extracardiac tumor. Of the four cases of extracardiac tumor, three had lung cancer infiltrating the pulmonary vein and left atrium, 10,11,14) and one had phyllodes tumor of the breast with pulmonary metastasis invading the pulmonary vein. 1) The thrombus retrieved from our patient pathologically consisted of 70% thrombotic components and 30% tumor components.…”

Section: Discussionmentioning

confidence: 99%

“…As the thrombotic components, recanalization may have been achieved if IV rt-PA therapy had been performed. Concerning MT for tumor embolism, Tsurusaki et al 14) reported that the hardness of the embolus is an important factor for recanalization, and that the push and fluff method using a Trevo was effective for a hard embolus of pulmonary squamous cell carcinoma. We also used the Trevo to treat our patient, deploying it by unsheathing, and were able to retrieve the embolus by one pass using the combined technique.…”

Section: Case Presentationmentioning

confidence: 99%

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Mechanical Thrombectomy for Acute Middle Cerebral Artery Occlusion Caused by Tumor Embolism: A Case Report

Moriyama

Sugiura

Hayashi

et al. 2021

JNET

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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.

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Section: Case Presentationcontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Case Presentationmentioning

confidence: 99%

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Mechanical Thrombectomy for Acute Middle Cerebral Artery Occlusion Caused by Tumor Embolism: A Case Report

Moriyama

Sugiura

Hayashi

et al. 2021

JNET

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“… 2) On the other hand, extracardiac carcinoma is a rare cause of cerebral embolism, and only five cases treated with MT have been reported previously. 3 - 7) A case of acute ischemic stroke arising from tumor embolism of lung cancer that invaded the pulmonary vein and left atrium and was successfully recanalized with MT is presented.…”

Section: Introductionmentioning

confidence: 99%

A Case of Cerebral Tumor Embolism from Extracardiac Lung Cancer Treated by Mechanical Thrombectomy

Oyama

Asai

Miyazawa

et al. 2020

NMC Case Report Journal

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Cerebral tumor embolism is a rare cause of acute ischemic stroke, and extracardiac carcinoma is an extremely rare cause. A 34-year-old man who had been diagnosed with lung cancer developed right hemiparesis and aphasia, with the National Institutes of Health Stroke Scale (NIHSS) score of 17. Magnetic resonance imaging (MRI) showed early ischemic change in the insular cortex and frontotemporal lobe and left internal carotid artery (ICA) terminal occlusion was confirmed by magnetic resonance angiogram (MRA). Mechanical thrombectomy (MT) with contact aspiration by a Penumbra ACE 68, followed by combined technique with a stent retriever was performed, and a soft, fragile embolus was retrieved. Finally, good recanalization was achieved (Thrombolysis in Cerebral Infarction [TICI] scale 2b), and on the next day, the right hemiparesis and aphasia were improved. However, the patient’s general condition gradually worsened, and 43 days after thrombectomy, he died from respiratory failure. The retrieved embolus was examined pathologically and diagnosed as mucoepidermoid carcinoma of the same type as his lung cancer. Chest computed tomography (CT) showed that tumor invaded the right pulmonary vein and left atrium; these findings suggested that a piece of the tumor in the left atrium flowed into the left ICA and caused the acute ischemic stroke.

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Mechanical thrombectomy for the treatment of large vessel occlusion due to cancer-related cerebral embolism: A systematic review

Toruno,

Al-Janabi,

Karaman

et al. 2024

Interv Neuroradiol

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Background Cancer-related cerebral embolism due to direct tumor embolization results in a rare acute ischemic stroke with large vessel occlusion (LVO). Despite the established status of mechanical thrombectomy (MT) in LVO management, its effectiveness and safety remains inadequately explored in this specific patient group. Methods We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using the Nested Knowledge AutoLit software, encompassing databases like Embase, PubMed, Scopus, and Web of Science, from their inception up to 9 May 2023. Results In the review of 35 studies encompassing 37 cases, mean patient age was 52 years, and 30% were female. Cardiac myxoma (29.7%), cardiac papillary fibroelastoma (16.2%), and squamous cell carcinoma of the lung (8.1%) were the most frequent underlying cancers. The left middle cerebral artery was the most commonly affected occlusion site (24.3%). Of the patients, 67.5% underwent MT alone, while 32.5% received MT combined with intravenous thrombolysis. Successful reperfusion (thrombolysis in cerebral infarction (TICI) 2b–3) was achieved in 89.1% of cases, with 59.4% reaching TICI 3. Functional independence was observed in 29.7% of patients. Conclusion While limitations exist, this comprehensive study highlights the potential benefits of MT in a patient group historically excluded from major trials, warranting further investigation.

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A Case of Mechanical Reperfusion Therapy for Cerebral Infarction Induced by Tumor Embolism from Lung Cancer

Cited by 10 publications

References 18 publications

Mechanical Thrombectomy for Acute Middle Cerebral Artery Occlusion Caused by Tumor Embolism: A Case Report

Mechanical Thrombectomy for Acute Middle Cerebral Artery Occlusion Caused by Tumor Embolism: A Case Report

A Case of Cerebral Tumor Embolism from Extracardiac Lung Cancer Treated by Mechanical Thrombectomy

Mechanical thrombectomy for the treatment of large vessel occlusion due to cancer-related cerebral embolism: A systematic review

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