Successful Recanalization and Neurological Restoration in Cancerous Embolic Cerebral Infarction via Endovascular Stent-Retriever Embolectomy

Abstract

Mechanical thrombectomy has emerged as a promising treatment for acute ischemic stroke caused by large vessel occlusion. However, cases involving cancerous emboli retrieved during endovascular embolectomy are rare. We present a case of a 65-year-old man with a history of heavily treated rectal cancer, who developed a middle cerebral artery (MCA) infarction due to metastatic adenocarcinoma. The patient presented with sudden onset right-side weakness, right facial palsy, global aphasia, and left gaze deviation, with a National Institutes of Health Stroke Scale (NIHSS) score of 16. Following intravenous thrombolysis, endovascular thrombectomy was performed, achieving nearly complete recanalization. Pathological examination of the retrieved thrombus revealed metastatic adenocarcinoma of rectal origin. The patient’s neurological deficits gradually improved, and he was successfully discharged to undergo further palliative therapy. This case underscores the importance of considering mechanical thrombectomy for patients with advanced solid organ malignancy presenting with acute ischemic stroke, even when the etiology could be a tumor embolus. Our findings highlight the potential for mechanical thrombectomy to restore neurological function in such cases, allowing patients to proceed to the next level of care with a reasonably good post-stroke quality of life.

Keywords:

• mechanical thrombectomy
• hematogenous spread
• cerebral thrombosis
• ischemic stroke
• large vessel obstruction
• endovascular embolectomy

Ethics Statement

The patient is deceased; therefore, we sought permission and obtained written consent for publication from the patient’s next of kin. A copy of the signed consent form has been submitted along with the manuscript to the journal. Institutional approval was not required to publish this case report. We wrote this case report adhering to the CARE guidelines to ensure all key details about the case were reported and submitted the checklist with the report.

Disclosure

The authors report no conflicts of interest in this work.