Neoplastic embolization to systemic and pulmonary arteries.

Area of Science:

• Cardiovascular Pathology
• Oncology
• Thromboembolism

Background:

• Arterial neoplastic emboli are uncommon, comprising less than 1% of thromboemboli.
• These events can lead to significant patient morbidity and mortality.

Purpose of the Study:

• To document the incidence, clinical presentations, and complications of arterial neoplastic emboli.
• To emphasize the importance of routine histologic examination of thrombectomy specimens.
• To review 11 cases from a single center and compare with existing literature.

Main Methods:

• Retrospective review of pathology archives for arterial emboli containing neoplasm (1998-2014).
• Histopathology review for diagnosis confirmation.
• Abstraction of patient demographics and oncologic history.
• Comprehensive literature review of 332 patients (1930-2016).

Main Results:

• Eleven patients identified, median age 63 years; embolism was the primary diagnosis in 64% of cases.
• Cardiac involvement (primary or metastasis) was present in over half of the cohort.
• Pulmonary and gastrointestinal primaries were the most common origins; 30% had sentinel neoplasia identification.

Conclusions:

• Routine histopathologic evaluation of embolectomy specimens is vital.
• This practice aids in diagnosing arterial neoplastic emboli in patients with or without prior cancer diagnosis.
• Early identification can potentially improve patient outcomes.