title: Recurrent lower limb embolism from thoracic aortic mural thrombus: a rare presentation of occult malignancy.
abstract: Initial presentation of a malignant disease as recurrent attacks of lower limb ischaemia due to emboli from a mural thrombus in the descending thoracic aorta is extremely rare. A diagnosis of malignancy may thus easily be overlooked. Recent advances in imaging technology have made the diagnosis of thoracic aortic mural thrombi much easier. Occult malignancy should always be suspected in the absence of biochemical evidence of hypercoagulability. We report on a patient with underlying malignant disease who presented with lower limb ischaemia that was relieved by axillobifemoral bypass.
authors.affiliation: Department of Surgery, Queen Elizabeth Hospital, 30 Gascoigne Road, Hong Kong. bonitahk@gmail.com
authors.forename: H K
authors.initials: HK
authors.lastname: Mark
authors.forename: N S
authors.initials: NS
authors.lastname: Ho
authors.forename: C C W
authors.initials: CC
authors.lastname: Tse
authors.forename: L F
authors.initials: LF
authors.lastname: Tang
authors.forename: S T
authors.initials: ST
authors.lastname: Hwang
mesh_terms: D001012:Aorta, Abdominal / Q000000981:diagnostic imaging*; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001366:Axillary Artery / Q000601:surgery; D001807:Blood Vessel Prosthesis; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007511:Ischemia / Q000209:etiology; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000150:complications*; D011859:Radiography; D012008:Recurrence; D013927:Thrombosis / Q000209:etiology*; D014656:Vascular Surgical Procedures