Myocardial infarction due to tumor embolization following pulmonary resection.

A fatal case of massive systemic tumor embolization, with involvement of the coronary arteries, which occurred following resection of a metastatic pulmonary fibroliposarcoma, is presented. Elevation of the cardiac specific creatine kinase isoenzyme (MB-CK) documented myocardial damage due to obstruction of the coronary arteries by tumor emboli. The preoperative computed tomography scan demonstrated contiguity between the pulmonary mass, the inferior pulmonary vein and left atrium. In future cases this finding should alert the surgeon that cardiopulmonary bypass and removal of the left artial extension of the tumor under direct vision may be required to prevent embolization during pulmonary resection.