Thromboembolism An unusual way of tissue diagnosis of Squamous Cell Carcinoma of Lungs

Abstract

Lung carcinoma presents in multifarious ways from incidental imaging finding to respiratory or systemic symptoms secondary to local invasion or metastasis. We report an atypical presentation of lung cancer. A 69-year-old male presented with sudden onset bilateral lower extremity weakness. He had cold bilateral lower extremity with no palpable pulses or Doppler signals in the lower extremity. A computed tomographic angiographic (CTA) scan revealed large thrombus in the infra-renal aorta and bilateral common iliac arteries with total occlusion. Bilateral endovascular thrombectomy along with fasciotomy was done. Immuno-histochemical staining of thrombectomy mass showed metastatic squamous cell carcinoma. Positron emission tomography (PET) scan revealed hypermetabolic right pulmonary hilar foci with hypermetabolic mediastinal nodes. Diagnosis of non-small cell lung carcinoma was made and subsequently, chemotherapy was started. Atypical presentation and tissue diagnosis of lung cancer via histopathological examination from endovascular thrombectomy are quite unique. Our case highlights the importance of analysis of thrombectomy mass.