Abstract
We report an extremely rare case of acute arterial obstruction caused by a tumor thrombus with a final diagnosis of esophageal tumor. A 68-year-old man complaining of sudden pain in his bilateral lower extremities was referred to our institute. Since contrast-enhanced computed tomography revealed occlusions of bilateral popliteal arteries he underwent emergency surgery on the day of admission. Bilateral longitudinal incisions from the popliteal arteries to the tibioperoneal trunks were made, and patch angioplasty using autologous saphenous vein graft were performed after the removal of the thrombi of both lesions. On the second post-operative day, as he complained of abdominal pain with a concurrent significant drop in his blood pressure and the rapid progression of anemia, he underwent emergency endoscopy on suspicion of upper gastrointestinal bleeding. Tumor lesions were identified in the thoracic esophagus and the gastroesophageal junction. Spindle cell carcinoma was detected by microscopic examination of biopsy specimens, but these histopathologic findings differed from those of the embolic material at the time of operation. He was subsequently transferred to another hospital for treatment for esophageal cancer and investigation of another primary tumor.
