Unusual presentation of bronchogenic carcinoma: Case report and review of the literature

Abstract

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.

Arterial tumour embolism causing acute limb ischaemia

“…Noncardiac tumours represent a small percentage of the causes. Tumour emboli in the peripheral arteries generally originate from advanced primary or metastatic lung malignancies that have invaded the pulmonary veins 1 –4 . The autopsy of the present case, however, revealed no evidence of pulmonary vein invasion.…”

Massive tumor embolism in the abdominal aorta from pulmonary squamous cell carcinoma: Case report and review of the literature

“…Most of them are associated with primary or secondary pulmonary malignancies, which occurred during intraoperative and postoperative periods. Only 11 cases of histologically proven primary pulmonary malignancies have been reported, in which spontaneous arterial tumor embolism caused sudden onset of symptoms . Among them, tumor emboli were seen in common femoral artery in four cases; in multiple arteries further from aorta in two cases; and in coronary artery, iliac artery, posterior cerebral artery, left cerebral artery and profunda femoris artery, and visceral artery in one case each.…”

A Rare Clinical Entity of Lung Cancer: Metastatic Peripheral Arterial Embolism

“…Peripheral arterial embolism arising from lung cancer is uncommon (1)(2)(3)(4). Malignant primary lung tumors invading pulmonary vessels, atrial myxomas and other primary cardiac tumors are the main causes of arterial embolism, which is a very unusual clinical entity (5).…”