Histology of Thrombectomy Specimen Reveals Cardiac Tumor Embolus in Cryptogenic Young Stroke

Salam, KA; Rafeeque, Mohammed; Hashim, Hisham; Mampilly, Neena; Noone, Mohan Leslie

doi:10.1016/j.jstrokecerebrovasdis.2017.11.015

Cited by 5 publications

(3 citation statements)

References 5 publications

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“…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%

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: Discussionmentioning

confidence: 99%

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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“…It is well documented that ischemic stroke can be caused by emboli from intracardiac tumors of cardiac origin, and several of these cases have been treated with mechanical embolectomy. [5][6][7][8][9][10][11] Zander et al 12 and Pop et al 13 have each reported a case of noncardiac tumor emboli (lung carcinoma and sarcomatoid thoracic carcinoma, respectively) treated with endovascular embolectomy. Our case represents the third such case of a noncardiac tumorrelated stroke treated with endovascular embolectomy.…”

Section: Discussionmentioning

confidence: 99%

Successful endovascular removal of a chondroblastic osteosarcoma embolus within the left middle cerebral artery

Soto

Reed

Benardete

2020

Baylor University Medical Center Proceedings

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“…136 Observation of fungal hyphae confirmed cases of septic embolus 137 and angioinvasive mucormycosis secondary to sinusitis. 138 Identification of papillary fronds or myxomatous tissue helped diagnose embolization secondary to cardiac papillary fibroelastoma 15,16,20 and myxoma, 29 respectively. Visual assessment and histopathology identified valve tissue, 24 calcifications, 27,30 chordae tendineae, 21 and aortic wall tissue 23 as embolism sources, which detached spontaneously or periprocedurally during valve replacement surgery.…”

Section: Relationship Between Thrombus Features and Stroke Etiologymentioning

confidence: 99%

Clot Composition Analysis as a Diagnostic Tool to Gain Insight into Ischemic Stroke Etiology: A Systematic Review

et al. 2021

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Mechanical thrombectomy renders the occluding clot available for analysis. Insights into thrombus composition could help establish the stroke cause. We aimed to investigate the value of clot composition analysis as a complementary diagnostic tool in determining the etiology of large vessel occlusion (LVO) ischemic strokes (International Prospective Register of Systematic Reviews [PROSPERO] registration # CRD42020199436). Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we ran searches on Medline (using the PubMed interface) and Web of Science for studies reporting analyses of thrombi retrieved from LVO stroke patients subjected to mechanical thrombectomy (January 1, 2006 to September 21, 2020). The PubMed search was updated weekly up to February 22, 2021. Reference lists of included studies and relevant reviews were hand-searched. From 1,714 identified studies, 134 eligible studies (97 cohort studies, 31 case reports, and six case series) were included in the qualitative synthesis. Physical, histopathological, biological, and microbiological analyses provided information about the gross appearance, mechanical properties, structure, and composition of the thrombi. There were non-unanimous associations of thrombus size, structure, and composition (mainly proportions of fibrin and blood formed elements) with the Trial of Org 10172 in Acute Stroke Treatment (TOAST) etiology and underlying pathologies, and similarities between cryptogenic thrombi and those of known TOAST etiology. Individual thrombus analysis contributed to the diagnosis, mainly in atypical cases. Although cohort studies report an abundance of quantitative rates of main thrombus components, a definite clot signature for accurate diagnosis of stroke etiology is still lacking. Nevertheless, the qualitative examination of the embolus remains an invaluable tool for diagnosing individual cases, particularly regarding atypical stroke causes.

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Histology of Thrombectomy Specimen Reveals Cardiac Tumor Embolus in Cryptogenic Young Stroke

Cited by 5 publications

References 5 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

Successful endovascular removal of a chondroblastic osteosarcoma embolus within the left middle cerebral artery

Clot Composition Analysis as a Diagnostic Tool to Gain Insight into Ischemic Stroke Etiology: A Systematic Review

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