Tumor embolus due to uterine cancer

Although the majority of arterial emboli are thrombi originating from the heart, emboli of other origin do occur. The purpose of this paper is to report a case of tumor embolus of a brachial artery.

A 64-year-old woman was referred for vascular surgery due to acute right upper-limb ischemia. ECG showed sinus rhythm without ischemic changes. Four years earlier the patient had undergone total hysterectomy with bilateral adnexotomy for endometrial adenocarcinoma with subsequent radiotherapy. Emergency embolectomy under local anesthesia was performed with uneventful recovery. Because of an atypical appearance resembling fatty tissue, the embolic material was sent for microscopic examination that revealed carcinoma cells. Chest X-ray and CT-guided biopsy showed previously unknown pulmonary metastasis. In spite of chemotherapy, the patient died one year later due to progression of the neoplastic disease. The literature and common features of tumor embolus are reviewed. This may be the first reported case of tumor peripheral arterial embolus caused by endometrial adenocarcinoma

Although tumor emboli are a rarely described cause of acute limb ischemia, pathological examination of the embolic material seems to be indicated, especially in patients with an unknown source of emboli and in every case of an atypical appearance.