Tumor Emboli from Aortic Metastasis.

The patient was a 67-year-old man with cholangiocarcinoma who underwent partial hepatectomy. At 34 months after surgery, descending aortic wall thickening was observed on contrast-enhanced CT (Picture A and B). Fluorodeoxyglucose positron emission tomography (FDG-PET) scans showed an increased uptake in this lesion (Picture G).

Picture.

Thereafter, the aortic wall thickness gradually increased, and the wall of the superior mesenteric artery (SMA) also thickened (Picture C and D).

After 6 months, a CT scan was performed because of severe abdominal pain. As wall thickening of the SMA had partly disappeared, part of the lesion was suggested to be an embolus (Picture E and F; arrow). Angiography demonstrated total occlusion of the SMA (Picture H; arrow). Thromboaspiration was immediately performed using a catheter. A pathological analysis of the embolus demonstrated tumor emboli from cholangiocarcinoma metastasis (Picture I).

Aortic metastasis is very rare. Similarly to cases involving primary aortic tumors, arterial tumor embolization in cases involving aortic metastasis is a clinical problem (1,2).

The authors state that they have no Conflict of Interest (COI).