Cerebral tumor embolism from thyroid cancer treated by mechanical thrombectomy: illustrative case

• Published in: Journal of Neurosurgery: Case Lessons Vol. 5; no. 5
• Main Authors: Fujiwara, Yuta, Hayashi, Kentaro, Shibata, Yohei, Furuta, Tatsuya, Yamasaki, Tomohiro, Yamamoto, Kazuhiro, Uchimura, Masahiro, Nakagawa, Fumio, Kambara, Mizuki, Nagai, Hidemasa, Akiyama, Yasuhiko
• Format: Journal Article
• Language: English
• Published: United States Journal of Neurosurgery Publishing Group (JNSPG) 30.01.2023; American Association of Neurological Surgeons
• Subjects: Case Lesson; mechanical thrombectomy; cerebral tumor embolism; thyroid cancer
• ISSN: 2694-1902; 2694-1902
• DOI: 10.3171/case22293

Development in mechanical thrombectomy is progressing dramatically. Tumor embolism has been rarely reported on the basis of pathological study of the retrieved thrombus. Herein, the authors report a case of cerebral tumor embolism from advanced thyroid cancer, which was successfully treated with mechanical thrombectomy. A 57-year-old man was diagnosed with thyroid cancer with multiple lung metastases and chemotherapy was planned. He experienced left hemiparesis and was bought to the emergency section of the authors' hospital. Magnetic resonance angiography revealed right internal carotid artery occlusion and endovascular treatment was performed. Using a combination of aspiration catheter and stent retriever, white jelly-like embolus was retrieved. The pathological study demonstrated thyroid cancer embolism. Pulmonary vein invasion following lung metastasis of thyroid cancer was most presumably the cause of the tumor embolism. Lung metastasis invading the pulmonary vein may be a cause of tumor embolism. Mechanical thrombectomy using a combination of stent retriever and aspiration catheter is effective in removing the tumor embolus and the pathological examination of the embolus is essential.