Key result
Mechanical thrombectomy retrieved a white embolus from the basilar artery, pathologically confirmed as a malignant melanoma metastasis originating from pulmonary vein invasion.
Case Report (n=1)
No
Tumor emboli from malignant melanoma can present as macroscopically white emboli and cause acute ischemic stroke, highlighting the importance of pathological analysis of clots retrieved during mechanical thrombectomy.
Pathological analysis of retrieved emboli may uncover occult malignancy; hypothesis-generating and should not yet change practice.
An 80-year-old woman presented with impaired consciousness after malignant melanoma resection. Magnetic resonance angiography showed basilar artery occlusion, which was subjected to mechanical thrombectomy for recanalization. A pathological analysis of the retrieved embolus revealed that it was derived from a metastasis of malignant melanoma. Contrast-enhanced chest computed tomography showed multiple pulmonary metastases, one of which was in the right upper lobe and invaded the pulmonary vein. To our knowledge, this is the first case of white embolus-induced cerebral embolism due to pulmonary vein invasion of a metastasis of a pathologically diagnosed malignant melanoma.
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Nukata et al. (2023) conducted a case report in Basilar artery occlusion due to tumor embolism (n=1). Mechanical thrombectomy was evaluated on Recanalization and pathological diagnosis. Mechanical thrombectomy retrieved a white embolus from the basilar artery, pathologically confirmed as a malignant melanoma metastasis originating from pulmonary vein invasion.
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