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Case report demonstrating radiological progression of polymethylmethacrylate distribution in asymptomatic pulmonary
1Department of Radiology, Queen Mary Hospital, 102 Pok Fu Lam Road, Hong Kong.
Abstract:
This case report describes a 50-year-old male with metastatic colorectal carcinoma and pathological fractures of T4 and T8 vertebrae, subsequently managed with vertebroplasty. Post-operative day one chest radiograph revealed polymethylmethacrylate (PMMA) extravasation into the azygos vein, but not in pulmonary arteries. Follow-up radiograph in one week showed progressive radiological migration of PMMA into bilateral pulmonary arteries, confirmed by contrast-enhanced computed tomography. The patient remained asymptomatic all along and was under conservative management. Stable cement distribution was maintained afterwards for 5 years. This case highlights the rarely reported radiological progression of cement pulmonary embolism in asymptomatic patient, discusses potential mechanisms and management strategies.
Insights
A case report details a patient with metastatic colorectal cancer who experienced polymethylmethacrylate (PMMA) cement migration into pulmonary arteries after vertebroplasty. The patient remained asymptomatic, highlighting rare radiological progression and conservative management strategies.
Area of Science:
- Interventional Radiology
- Oncology
- Neurosurgery
Background:
- Metastatic colorectal carcinoma can lead to pathological vertebral fractures.
- Vertebroplasty is a common treatment for such fractures, involving the injection of polymethylmethacrylate (PMMA) cement.
- Complications, though rare, can include cement extravasation and embolism.
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