doi: 10.2169/internalmedicine.9696-17 Intern Med 57: 907-908, 2018 http://internmed.jp
【 PICTURES IN CLINICAL MEDICINE 】
Tumor Emboli from Aortic Metastasis Yohei Ikebe 1, Eijun Sueyoshi 1, Hideki Ishimaru 1 and Masaaki Hidaka 2 Key words: aorta, metastasis, emboli, imaging
(Intern Med 57: 907-908, 2018) (DOI: 10.2169/internalmedicine.9696-17)
Picture.
The patient was a 67-year-old man with cholangiocarcinoma who underwent partial hepatectomy. At 34 months after surgery, descending aortic wall thickening was observed on contrast-enhanced CT (Picture A and B). Fluorodeoxyglucose positron emission tomography (FDG-PET) scans showed an increased uptake in this lesion (Picture G). Thereafter, the aortic wall thickness gradually increased,
and the wall of the superior mesenteric artery (SMA) also thickened (Picture C and D). After 6 months, a CT scan was performed because of severe abdominal pain. As wall thickening of the SMA had partly disappeared, part of the lesion was suggested to be an embolus (Picture E and F; arrow). Angiography demonstrated total occlusion of the SMA (Picture H; arrow).
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Department of Radiological Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Japan and ２ Department of Surgery, Graduate School of Biomedical Sciences, Nagasaki University, Japan Received: June 21, 2017; Accepted: July 19, 2017; Advance Publication by J-STAGE: December 8, 2017 Correspondence to Dr. Eijun Sueyoshi,
[email protected]
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Intern Med 57: 907-908, 2018
DOI: 10.2169/internalmedicine.9696-17
Thromboaspiration was immediately performed using a catheter. A pathological analysis of the embolus demonstrated tumor emboli from cholangiocarcinoma metastasis (Picture I). Aortic metastasis is very rare. Similarly to cases involving primary aortic tumors, arterial tumor embolization in cases involving aortic metastasis is a clinical problem (1, 2).
References 1. Ugurlu BS, Hazan E, Badak O, Yörüko!lu K, Oto O. Dissection of the ascending aorta due to metastatic carcinoma. Ann Thorac Surg 72: 614-615, 2001. 2. Choi H, Yoon HJ, Jang WI, Kim CY, Doh JH. Concealed primary aortic sarcoma induced hypertensive encephalopathy resulting from a thoracic aortic occlusion: a case report. J Cardiothorac Surg 8: 102, 2013.
The authors state that they have no Conflict of Interest (COI). The Internal Medicine is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/ by-nc-nd/4.0/).
Ⓒ 2018 The Japanese Society of Internal Medicine Intern Med 57: 907-908, 2018
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