Abstract：
BACKGROUND: Acute tumour embolism to the popliteal artery resulting in limb-threatening ischemia is a rare complication of neoplastic disease. Generally, tumors embolize to the pulmonary circulation via the venous system. In this case, the originating tumor was a lung cancer of a large size and advanced stage that had invaded the left atrium of the heart and disseminated in the systemic circulation. The tumor likely fragmented, resulting in showering to the right popliteal artery, superior mesenteric artery, and left renal artery, which is a unique presentation of tumor embolism.
METHODS: We present a case of a 62-year-old Caucasian gentleman with a large left lower lobe squamous cell lung cancer that had invaded into the left atrium via the pulmonary veins. He presented with acute limb threatening ischemia. A computed tomographic angiogram revealed an occlusion of the left popliteal artery as well as embolization to the superior mesenteric artery and the right renal artery. He was started on intravenous heparin and underwent an emergency popliteal embolectomy and calf fasciotomies, which was limb saving. His fasciotomy wounds were closed after 1 week and he was discharged on anticoagulation.
CONCLUSIONS: This is a rare case of tumor embolism resulting in both an embolectomy and calf fasciotomies. In the light of such cases, we suggest that tumors invading the bloodstream should be considered high risk for embolization and hypothesize that prophylactic antithrombotic therapy may avoid major morbidity.
METHODS: We present a case of a 62-year-old Caucasian gentleman with a large left lower lobe squamous cell lung cancer that had invaded into the left atrium via the pulmonary veins. He presented with acute limb threatening ischemia. A computed tomographic angiogram revealed an occlusion of the left popliteal artery as well as embolization to the superior mesenteric artery and the right renal artery. He was started on intravenous heparin and underwent an emergency popliteal embolectomy and calf fasciotomies, which was limb saving. His fasciotomy wounds were closed after 1 week and he was discharged on anticoagulation.
CONCLUSIONS: This is a rare case of tumor embolism resulting in both an embolectomy and calf fasciotomies. In the light of such cases, we suggest that tumors invading the bloodstream should be considered high risk for embolization and hypothesize that prophylactic antithrombotic therapy may avoid major morbidity.
摘要：
背景：导致威胁肢体缺血的pop动脉急性肿瘤栓塞是肿瘤性疾病的罕见并发症。一般来说,肿瘤通过静脉系统栓塞到肺循环。在这种情况下,原发肿瘤是一种大型晚期肺癌，已侵入心脏左心房并在体循环中扩散。肿瘤可能碎裂，导致淋雨到右动脉，肠系膜上动脉,和左肾动脉,这是肿瘤栓塞的独特表现。
方法：我们介绍了一例62岁的高加索绅士，患有大的左下叶鳞状细胞肺癌，通过肺静脉侵入左心房。他表现为急性肢体威胁缺血。计算机断层扫描血管造影显示左pop动脉闭塞以及肠系膜上动脉和右肾动脉的栓塞。他开始静脉注射肝素，并接受了紧急的the栓子切除术和小腿筋膜切开术，这是拯救肢体的。1周后，他的筋膜切开术伤口闭合，并抗凝出院。
结论：这是一例罕见的肿瘤栓塞病例，导致栓子切除和小腿筋膜切开术。鉴于这种情况，我们建议,肿瘤侵入血流应被认为是栓塞的高风险,并假设预防性抗血栓治疗可以避免重大发病率.
方法：我们介绍了一例62岁的高加索绅士，患有大的左下叶鳞状细胞肺癌，通过肺静脉侵入左心房。
结论：这是一例罕见的肿瘤栓塞病例，导致栓子切除和小腿筋膜切开术。
