An Atypical Presentation of a Saddle Embolism in the Setting of Malignancy.

Division

West Florida

Hospital

St. Petersburg General Hospital

Document Type

Case Report

Publication Date

3-29-2024

Keywords

computed tomography pulmonary angiography, pulmonary thrombectomy, renal cell carcinoma (rcc), saddle pe, v/q scan

Disciplines

Cardiovascular Diseases | Diagnosis | Family Medicine | Medicine and Health Sciences

Abstract

A 52-year-old male presented to the emergency room with acute abdominal pain. Imaging determined acute appendicitis, with an incidental finding of a renal mass. The biopsy was positive for renal cell carcinoma, and the patient underwent simultaneous appendectomy and nephrectomy. Postoperatively, the patient developed hypoxia at night with exertion, requiring oxygen supplementation. The remainder of his vital signs were stable. Due to renal function, a ventilation/perfusion (V/Q) scan was conducted, which showed a high probability of pulmonary embolism (PE). Follow-up computed tomography angiography of the chest showed a massive saddle embolism. Interventional radiology performed an uncomplicated thrombectomy, oxygen saturations improved, and the patient was discharged on apixaban.

Publisher or Conference

Cureus

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