PMC7451184_01
Coronal chest computed tomography (a) on admission (asterisk: tumor; LA: lung atrium; white arrows: pulmonary vein) and (b) after thrombectomy (asterisk: tumor; LA: lung atrium; white arrows: pulmonary vein). Tumor invasion of the pulmonary vein was not suspected.
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F1
Enhanced computed tomography (CT) performed on admission and after intervention did not reveal any emboli migrating into the pulmonary vein [Figure 1a and b].
(a) Diffusion-weighted magnetic resonance image of the brain depicting high-intensity signals in the area of the right internal cerebral artery (Alberta Stroke Program Early Computed Tomography Score of 5). (b) Angiography image showing occlusion of the middle cerebral artery (posteroanterior view). (c) Postthrombectomy right internal carotid artery angiography image demonstrating recanalization of the middle cerebral artery. (d) Excised tumor tissue consisted of a single mass that was reddish- white in color, cylindrical in shape, and exhibited elasticity.
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F2
Alberta Stroke Program Early CT Score was 5 [Figure 2a]. A cardiogenic embolism due to atrial fibrillation was suspected, and an emergency thrombectomy was planned. Emergency cerebral angiography revealed a right MCA occlusion at the M1 distal segment [Figure 2b]. Revascularization (thrombolysis incerebral infarction Grade 3) was confirmed through angiography performed 4 h 37 min after onset [Figure 2c]. The retrieved embolus differed substantially from a typical thrombus, as it was cylindrical, elastic, and whitish in color [Figure 2d].
Longitudinal (a) and transverse (b) sections of the excised tumor. Necrosis was detected in the core of the tumor.
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F3
The embolus excised from the intracranial vessel was 8 cm long and cylindrical, and pathological examination revealed central necrosis in the cross-sectional plane [Figure 3].