E-051 acute ischemic stroke due to tumorigenic embolism treated with mechanical thrombectomy

Abstract

Background Patients experiencing acute ischemic stroke due to intracranial occlusion of the proximal anterior circulation may benefit from intraarterial treatments, including intraarterial thrombolysis and/or mechanical thrombectomy. Recent publications have confirmed the efficacy and safety of these treatments. There are several cases in the literature in which mechanical thrombectomy was successful in treating acute stroke secondary to benign tumorigenic embolism. Methods We present a 49-year-old female with a history of peripheral nerve primitive neuroectodermal tumor (PNET) and pulmonary brain metastases, as well as a patent foramen ovale. This patient developed acute right upper extremity weakness, right facial droop and dysarthria. She was diagnosed with occlusion of the M1 segment of the left middle cerebral artery and treated with mechanical thrombectomy. Pathology of the thrombectomy specimen was compatible with metastatic sarcoma. Results Mechanical thrombectomy was successful and the patient had resolution of her acute stroke symptoms. To the best of our knowledge, this is the first case of acute ischemic stroke secondary to malignant tumorigenic embolism to be successfully treated with mechanical embolectomy. Conclusion In acute stroke secondary to malignant tumorigenic embolism, mechanical thrombectomy might be a safe and effective treatment option. Disclosures B. Bell: None. A. Saad: None. K. Layton: None. S. Shamim: None. G. Snipes: None. K. Hesselrode: None.