case report presented in CRISE 2015

1. Feasibility of Bronchial artery
embolization (BAE) for locally
aggressive endobronchial thyroid
carcinoma metastasis
S.A. Alzaabi, Z. Alsafran, A. Thuaimer, Y. Asiri, M.
Hazmi; Dammam/SA
The authors declare that there are no conflict of interest

2. Clinical summary
•We present a unique case of metasenchrinus
We present a unique case of middle age female
presented with prolonged clinically significant
hemoptysis secondary to endobronchial
papillary thyroid cancer (PTC) metastasis. This
was effectively treated with bland trans-catheter
BAE embolization resulting in complete
cessation of her active bleed.

3. clinical history
•A 55 year-old female with a 30 years history of primary papillary
thyroid cancer treated with left hemi thyroidectomy as the patient
refused a total resection at that time and followed by radioactive
iodine course
•In 2010, An idodine uatake scan shows evidence of local recurrence
with left lung metastasis. total thyroidectomy with lung lobectomy
was carried out. The patient underwent radiation therapy as well as
radioactive idodine treatment.
•In November 2014, she presented to the emergency department
with hemoptysis that started 9 months back and increase in amount
over time to become more frequent and gradual drop of hemoglobin.
•Physical examination the patient looks pale and lethargic.

7. Discussion
•
•Hemoptysis in patients with history of cancer generally occurs secondary to local necrosis and
inflammation of blood vessels within the tumor bed, rather than direct tumor invasion of
blood vessels(10). It has been found that bronchial arteries are responsible for hemorrhage in
more than 90% of cases with hemoptysis. Before introducing bronchial artery embolization
(BAE)was first introduced in 1974(11), conservative management or emergency surgical methods
were used to control hemoptysis (8).),

8. •
•The most disastrous complication after bronchial artery embolization
•is spinal cord ischemia due to the occlusion of spinal
•arteries, which has been reported in 0–6.5% of cases.
•Visualization of radicular branches on bronchial or intercostal
•angiograms is not an absolute contraindication to embolization.
•However, when the anterior spinal artery (artery of Adamkiewicz)
•is identified at arteriography, embolization should not be performed.
•Consequently, in order to decrease the risk of this dreaded
•complication, it is of utmost importance to visualize all bronchial
•and nonbronchial arteries prior to embolization(14). Luckily our patient went to
embolization with o major complications ,according to the Society of Interventional
Radiology(SIR)definitions, occurred. There were no complications such as spinal cord
ischemia, transient pleurisy,