Multiple instances of peripheral artery emboli from occult primary small cell lung cancer

Most peripheral artery emboli originate in the heart, and systemic neoplastic emboli are infrequently associated with bronchogenic carcinoma. To our knowledge, there have been no reports of pulmonary vein infiltration by small cell lung cancer.We describe a highly unusual case of multiple instances...

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Bibliographic Details
Published in:Texas Heart Institute journal 2012, Vol.39 (3), p.420-423
Main Authors: Gabrielli, Roberto, Rosati, Maria Sofia, Chiappa, Roberto, Vitale, Silvio, Millarelli, Massimiliano, Caselli, Giovanni
Format: Article
Language:English
Subjects:
Autopsy
Case Reports
Echocardiography, Doppler, Color
Echocardiography, Transesophageal
Embolectomy
Embolism - diagnosis
Embolism - etiology
Embolism - pathology
Embolism - surgery
Fatal Outcome
Humans
Ischemia - etiology
Ischemic Attack, Transient - etiology
Lung Neoplasms - complications
Lung Neoplasms - diagnosis
Lung Neoplasms - pathology
Male
Middle Aged
Neoplasms, Unknown Primary
Pulmonary Veins - diagnostic imaging
Pulmonary Veins - pathology
Small Cell Lung Carcinoma - complications
Small Cell Lung Carcinoma - diagnosis
Small Cell Lung Carcinoma - pathology
Tomography, X-Ray Computed
Treatment Outcome
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Summary:Most peripheral artery emboli originate in the heart, and systemic neoplastic emboli are infrequently associated with bronchogenic carcinoma. To our knowledge, there have been no reports of pulmonary vein infiltration by small cell lung cancer.We describe a highly unusual case of multiple instances of peripheral embolism as the first overt sign of occult primary small cell lung cancer. Tumor emboli infiltrated the pulmonary veins of a 62-year-old man who presented first with a transient ischemic attack and then with other ischemic symptoms. The uncommonly wide distribution of tumor emboli over a short time resulted in death.Improvements in diagnostic imaging have led to the early identification of relatively isolated small cell lung cancers. This patient's case underscores the importance of transesophageal echocardiography in detecting cardiac emboli when the cause of cerebral ischemic attack is unknown or if there might be multiple instances of arterial embolism. Computed tomography also has a role in the investigation of possible sources of emboli and unrecognized, asymptomatic embolization.
ISSN:0730-2347
1526-6702