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+A 73-year-old man who had been transferred to our emergency room due to sudden chest pain was diagnosed with ST-segment elevation myocardial infarction (STEMI).
+He had no coronary risk factors except for a history of smoking for 50 years.
+Primary percutaneous coronary intervention was performed, and a long, string-shaped contrast defect was observed in the left anterior descending artery (Fig.1A).
+Optical coherence tomography (OCT) imaging revealed an odd, smooth-surfaced 50-mm long object (Fig.1B).
+A long, white object which looked like a parasitic worm was retrieved via intracoronary aspiration and revascularization was successfully completed since neither plaque rupture or the presence of thrombus was detected by OCT (Fig.1C).
+On the eleventh hospital day, transthoracic echocardiography revealed a new floating object in the left atrium.
+Contrast computed tomography revealed a huge 7×6 cm mass that was recognized at admission in the right upper pulmonary lobe with direct pulmonary vein invasion (Fig.1D).
+Although the bronchoscopic findings were negative for a lung tumor, a histopathologic examination of the aspirated coronary object revealed pleomorphic lung carcinoma (Fig.2).
+The patient was diagnosed with STEMI due to coronary embolization associated with lung carcinoma.
+Brain MRI revealed that the patient had an asymptomatic cerebral infarction in the right frontal lobe and a small parietal lobe lesion was diagnosed to be metastasis.
+Given all these observations, he was diagnosed with right lung carcinoma, stage IV (c-T2bN2M1b).
+He was treated according to the chemotherapy regimens (carboplatin & paclitaxel) known to be effective for the treatment of advanced non-small cell lung cancer.
+He responded to the treatment and showed a good clinical course afterwards (Fig.3).
+Chemotherapy with a total of 9 cycles of the same regimen was used and the carcinoma progression was suppressed.
+He has been doing well for more than two years of PCI and has been followed-up regularly.