Bladder tumor unveiled by acute limb ischemia: a case report

Abstract Background Bladder cancer, particularly in advanced stages, is associated with an increased risk of thromboembolic events, including both venous and arterial complications. Tumor embolism in the arterial circulation is a rare, however, it may lead to limb-threatening conditions such as acute limb ischemia (ALI). Understanding the mechanisms behind tumor-related embolism and the importance of timely interventions is crucial, as this complication can significantly impact patient outcomes. This case contributes to the scientific literature by highlighting the relationship between bladder cancer and tumor embolism and the importance of rapid, effective treatment in such situations. Case presentation A 73-year-old male with a history of bladder cancer presented with acute limb ischemia in the left lower limb. The patient complained of sudden-onset pain, pallor, and coldness in the affected leg, with absent pulses. Imaging revealed a large embolus obstructing the femoral artery, which was suspected to have originated from the patient’s bladder tumor. An emergency embolectomy was performed using a Fogarty catheter, which successfully restored blood flow to the affected limb. Additionally, a bladder tumor resection was conducted under general anesthesia, due to the nature of the procedure and the patient's distress. Histopathological examination confirmed malignancy with muscle invasion. Conclusion This case emphasizes the rare but serious complication of tumor embolism in bladder cancer, leading to acute ischemic events. The use of a Fogarty catheter for embolectomy proved to be an effective and minimally invasive intervention, restoring limb perfusion and preventing irreversible damage. Clinicians should remain vigilant about the possibility of tumor-related thromboembolic complications, and a multi-disciplinary approach is essential for managing both acute ischemia and the underlying malignancy to optimize patient outcomes.