OncoTargets and Therapy (Jul 2024)
Successful Recanalization and Neurological Restoration in Cancerous Embolic Cerebral Infarction via Endovascular Stent-Retriever Embolectomy
Abstract
Li-Ying Ko,1 Victor C Kok,2 Chun-Hao Tang,3 Chien-Kuan Lee,4 Pao-Sheng Yen5 1Department of Neurology, Kuang Tien General Hospital, Taichung, Taiwan; 2Division of Medical Oncology, Cancer Center of Kuang Tien General Hospital, Taichung, Taiwan; 3Department of Family Medicine, Kuang Tien General Hospital, Taichung, Taiwan; 4Department of Pathology, Kuang Tien General Hospital, Taichung, Taiwan; 5Department of Neuroradiology, Kuang Tien General Hospital, Taichung, TaiwanCorrespondence: Pao-Sheng Yen, Department of Neuroradiology, Kuang Tien General Hospital, Taichung, Taiwan, No. 117, Shatian Road, Shalu District, Taichung, 433401, Taiwan, Tel +886 4-2662-5111, Email [email protected]: Mechanical thrombectomy has emerged as a promising treatment for acute ischemic stroke caused by large vessel occlusion. However, cases involving cancerous emboli retrieved during endovascular embolectomy are rare. We present a case of a 65-year-old man with a history of heavily treated rectal cancer, who developed a middle cerebral artery (MCA) infarction due to metastatic adenocarcinoma. The patient presented with sudden onset right-side weakness, right facial palsy, global aphasia, and left gaze deviation, with a National Institutes of Health Stroke Scale (NIHSS) score of 16. Following intravenous thrombolysis, endovascular thrombectomy was performed, achieving nearly complete recanalization. Pathological examination of the retrieved thrombus revealed metastatic adenocarcinoma of rectal origin. The patient’s neurological deficits gradually improved, and he was successfully discharged to undergo further palliative therapy. This case underscores the importance of considering mechanical thrombectomy for patients with advanced solid organ malignancy presenting with acute ischemic stroke, even when the etiology could be a tumor embolus. Our findings highlight the potential for mechanical thrombectomy to restore neurological function in such cases, allowing patients to proceed to the next level of care with a reasonably good post-stroke quality of life.Keywords: mechanical thrombectomy, hematogenous spread, cerebral thrombosis, ischemic stroke, large vessel obstruction, endovascular embolectomy
