A Case of Colon Cancer Causing Ulnar Artery Embolism, Cerebral Infarction, and Splenic Infarction due to Left Arterial Invasion of Metastases from the Lung

Abstract

Cardiac metastasis may rarely cause a tumor embolism. We experienced a case in which, after resection of sigmoid colon cancer, left atrial invasion of the metastasis from the lung caused a left ulnar artery embolism, cerebral infarction, and splenic infarction due to tumor embolism. The case was a 47-year-old female patient. Four years and 3 months after the resection of sigmoid colon cancer, bilateral lung metastasis was observed. We performed thoracoscopy-assisted left lung subsegmental resection in 2 stages. We post-operatively administered chemotherapy for 7 months, but after 2 years and 3 months, we observed metastasis again in the right lung. This recurrent metastatic cancer decreased in size after stereotactic irradiation, but 11 months after the recurrence, left upper arm pain occurred. Contrast-enhanced computed tomography revealed left atrial invasion metastasized from the lung and a left ulnar artery embolism. We performed removal of the embolus by a catheter and histopathologically diagnosed it as a tumor embolus. One month later, multiple cerebral infarctions occurred, and a further 2 weeks later, splenic infarction developed. Since there were no other factors such as arrhythmia and arteriosclerosis, we suggest that the series of disease progression was caused by multiple tumor embolisms due to the left atrial invasion of the lung metastasis from the sigmoid colon cancer. Subsequently, chemotherapy was administered, and the patient remains alive. In the case of a cancer-carrying patient, it is necessary to take into consideration a tumor embolism that may occur in multiple organs.