Carotid free-floating thrombus in woman with meningioma: a case report and review of the literature

L. Santoro, F. Schinzari, A. Di Veronica, C. Cardillo, A. Santoliquido

Department of Internal Medicine, Catholic University of the Sacred Heart, School of Medicine, Rome, Italy. lu_santoro@libero.it

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• Angiology

OBJECTIVE: Several reports have previously described the coexistence of severe carotid artery disorders and brain tumors, in particular meningioma, mainly consisting of arterial occlusion or obstruction due to direct compression by tumor mass, with possible presence of transient neurological symptoms as well as complete cerebral infarction.
Free-floating thrombus (FFT) is an uncommon condition, characterized by the presence of thrombotic material partially attached to the arterial wall with evidence of heartbeat associated floating.
To our knowledge, our case represents the first report in literature about presence of internal carotid FFT in patient affected by meningioma.

CASE REPORT: In this report, sharing singular images and videos of this uncommon condition, we present the first case of a right internal carotid artery FFT in a 59-year-old woman affected by meningioma, successfully treated with antiplatelet medication together with anticoagulation and high dose of statins.

CONCLUSIONS: Our case confirms the possible association between carotid artery disorders and meningioma, involving for the first time a FFT. These findings make desirable to explore carotid district in patients with brain tumors, especially meningioma, even if symptoms suggestive of ischemic suffering are not present, in order to make an early diagnosis, so preventing marked ischemic events.

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