Leiomyosarcoma Tumor Embolism Masquerading as Thrombus in Transit

Mesenteric and myocardial ischemia revealing lower limb sarcoma

Introduction and importance

Although most of the causes of acute superior mesenteric artery (SMA) embolism with a poor clinical course originate from the heart, we report a case of SMA embolism secondary to advanced sarcoma of the lower extremities.

Case presentation

A 66-year-old man presented with chest and epigastric discomfort that lasted for 1 day. Coronary angioplasty was performed, followed by laparotomy with an embolectomy of the SMA, small bowel resection, and ileostomy. After surgery, leiomyosarcoma was diagnosed on a biopsy performed in the left thigh, and lung metastasis was confirmed. He had recurrent peritonitis for 2 months and died of multiple organ failure.

Clinical discussion

The common etiologies of SMA embolism include cardioembolic sources with atrial fibrillation and recent myocardial infarction. Rare etiologies include atherosclerotic plaque, mural thrombus of the aneurysm, and cardiac sarcoma.

Conclusion

Efforts are required for the systemic evaluation of various etiologies in patients with SMA embolism who require rapid diagnosis and intervention.

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Mesenteric ischemia and myocardial ischemia caused by advanced sarcoma of lower extremities are rare.

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When evaluating patients with SMA embolism, systemic evaluation of various etiologies is required.

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We present a case of SMA embolism secondary to advanced sarcoma of the lower extremities.