A Malignant Case of Acute Promyelocytic Leukemia with Occlusion of Carotid Artery by Tumor Thrombus

We report an unusual and malignant presentation of acute promyelocytic leukemia (APL) resulting in thrombosis of a cervicocephalic artery by tumor in a healthy 37-year-old woman. The patient’s rapid decline and multiorgan involvement proved to be a diagnostic and therapeutic challenge, and despite the efforts of a coordinated multidisciplinary health care team, she suffered a cardiac arrest and died within 48 hours of presentation to the emergency department. Autopsy revealed an APL-related tumor thrombus obstructing the left internal carotid artery, which to the best of our knowledge has not yet been described as a cause of fatal stroke.