Neoplastic material inducing acute limb ischemia during bilobectomy surgery for the treatment of lung cancer

• Acute limb ischemia caused by neoplastic embolism after bilobectomy surgery is rare but highly morbid. • Emergent vascular surgery consultation is essential in all cases of acute limb ischemia. • Routine pathological examination of all thrombectomy material should be standard to identify potential tumor embolism. Arterial tumor embolization is a severe but rare complication in lung cancer, especially during surgical interventions. We present the case of acute lower limb ischemia developed during a bilobectomy surgery for non-small cell lung carcinoma. Postoperative embolectomy was performed after a CT angiogram identified an occlusive thrombus in the left common iliac artery. Pathological analysis confirmed non-small cell lung carcinoma within the thrombus. Despite successful surgery, the patient later developed cerebral metastasis and chose medical assistance in dying. This case underscores the importance of adopting an open revascularization approach for patients suspected of acute arterial occlusion caused by intraluminal tumors.