Esophageal squamous cell carcinoma presenting with systemic arterial embolism

Abstract

Acute arterial occlusion as a result of embolization from a malignant tumor is rare and infrequently reported. Recently a 70-year-old man initially presented with acute arterial occlusion of the left lower limb. He underwent embolectomy, and embolus was diagnosed as a squamous cell carcinoma histologically. Subsequent upper gastrointestinal endoscopy showed superficial esophageal cancer in the thoracic esophagus. Although scheduled to undergo chemotherapy, he died of acute pneumonia on the 81st day from onset. Autopsy showed superficial esophageal cancer, measuring 1.5 cm in diameter, and widespread tumor extension into arterial vessels such as the left femoral artery, the superior mesenteric artery, bilateral intrapulmonary arteries and veins such as bilateral brachiocephalic vein to the supra vena cava, despite small tumor size and shallow tumor invasion depth of the submucosal layer. This case is particularly interesting because the cancer manifested as arterial cancer embolism.