Although hematogenous metastasis ordinarily involves the embolization of tumor cells singly or in microscopic aggregates, it is distinctly unusual for the emboli to be large enough to result in clinically recognizable infarction.1,2 We have recently cared for a patient with widely disseminated adenocarcinoma of the colon characterized by a particular propensity for hematogenous metastases who died of acute myocardial and cerebral infarction secondary to arterial embolism of tumor. We report the case herein with a brief review of the literature.
A 72-year-old white widow, when seen by her physician in February 1965, had a history of intermittent rectal bleeding of 18 months' duration. X-ray study with barium enema revealed a sigmoid polyp which proved to be an adenocarcinoma. She underwent sigmoid resection with anastomosis of the descending colon to the rectum. The primary lesion extended only to the muscularis, but a single metastatic lymph node was