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Ann Thorac Surg 2004;77:1426-1428
© 2004 The Society of Thoracic Surgeons

Case report

Peripheral arterial embolism arising from pulmonary adenocarcinoma

Jesus Loscertales, MD, PhDa*, Miguel Congregado, MD, PhDa, Carlos Arenas, MD, PhDa, Andres Arroyo, MDa, Juan Carlos Giron, MDa, Javier Ayarra, MD, PhDa, Rafael Jimenez-Merchan, MD, PhDa

a Department of General and Thoracic Surgery, Virgen Macarena University Hospital, Seville, Spain

Accepted for publication April 11, 2003.

* Address reprint requests to Dr Loscertales, Hospital Universitario Virgen Macarena, Av Dr Fedriani No. 3, 41071 Seville, Spain
e-mail: jloscert{at}us.es

Bronchogenic carcinoma is a rare source of peripheral arterial embolism. We present the case of a 28-year-old female nonsmoker with an adenocarcinoma of the left main bronchus involving the pulmonary veins. While the patient was hospitalized awaiting operation, she presented embolization in her legs; embolectomy and fasciotomy were necessary to treat compartment syndrome. Echocardiography disclosed floating tumoral masses in the left atrium. Seven days later, an operation was performed with cardiopulmonary bypass to remove the tumor masses from the atrial lumen; pulmonary veins were sutured from within the atrium, and pneumonectomy was performed. Fulminant infection of the lower limbs developed that led to gangrene and multiple organ failure, and the patient died 8 days after the operation.




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