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NEUROSURGICAL ANESTHESIA

Perioperative Stroke Caused by Arterial Tumor Embolism

Douglas V. Brown, MD^*, L. Penfield Faber, MD, and Kenneth J. Tuman, MD^*

Departments of *Anesthesiology and Cardiovascular and Thoracic Surgery, Rush Medical College, Rush University Medical Center, Chicago, Illinois

Address correspondence and reprint requests to Douglas V. Brown, MD, Department of Anesthesiology, Rush Medical College, Rush University Medical Center, 1653 W. Congress Pkwy., Suite 739, Chicago, IL 60612. Address e-mail to douglas_brown{at}rush.edu

Rarely, cancer invades a pulmonary vein and subsequently embolizes to the cerebral circulation, causing a stroke. Tumor embolism typically involves large, centrally located lung tumors. We report a case of immediate postoperative stroke caused by an arterial tumor embolism during pulmonary resection of metastatic sarcoma. This case is unique because the resected lesions were smaller than those previously associated with tumor embolism and unusual in that the tumors were peripherally located. Tumor embolization should be considered in the differential diagnosis of stroke after lung cancer surgery even with small, peripherally located pulmonary malignancies.

IMPLICATIONS: We present a case of stroke diagnosed in the recovery room after lung cancer resection. The cause of the stroke was tumor that embolized from the lung to the middle cerebral artery. Tumor embolism should be considered in the differential diagnosis of immediate postoperative stroke after lung cancer surgery.

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999