Pulmonary Tumor Embolism and Pulmonary Tumor Thrombotic Microangiopathy Causing Rapidly Progressive Respiratory Failure: A Case Series

Kartikeya Rajdev, Ujjwal Madan, Sean McMillan, Kyle Wilson, Kurt Fisher, Ashley Hein, Amol Patil, Sabin Bista, Daniel Hershberger, Brian Boer

Research output: Contribution to journalArticlepeer-review

Abstract

Pulmonary tumor embolism (PTE) and pulmonary tumor thrombotic microangiopathy (PTTM) are rare etiologies for rapidly progressive dyspnea in the setting of undiagnosed metastatic cancer. They occur most frequently in association with adenocarcinomas, with PTE being most frequently associated with hepatocellular carcinoma and PTTM being most commonly reported with gastric adenocarcinoma. Pulmonary tumor embolism and PTTM appear to be a disease spectrum where PTTM represents an advanced form of PTE. Pulmonary tumor embolism and PTTM are mostly identified postmortem during autopsy as the antemortem diagnosis remains a clinical challenge due to the rapidly progressive nature of these rare diseases. We report 2 cases of rapidly progressive respiratory failure leading to death, due to tumoral pulmonary hypertension resulting from PTE and PTTM, diagnosed postmortem. Both of the patients were middle-aged females, nonsmokers, and had a gastrointestinal source of their primary malignancy.

Original languageEnglish (US)
JournalJournal of Investigative Medicine High Impact Case Reports
Volume10
DOIs
StatePublished - Mar 2022

Keywords

  • PTE
  • PTTM
  • autopsy
  • cor pulmonale
  • metastatic cancer
  • pulmonary tumor embolism
  • pulmonary tumor thrombotic microangiopathy
  • respiratory failure
  • tumoral pulmonary hypertension

ASJC Scopus subject areas

  • Epidemiology
  • Safety, Risk, Reliability and Quality
  • Safety Research

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