Pulmonary tumour thrombotic microangiopathy as a cause of new-onset pulmonary hypertension in a patient with metastatic low-grade serous ovarian cancer. uri icon

Overview

abstract

  • A 78-year-old woman with metastatic low-grade serous ovarian cancer presented with rapidly progressive exertional dyspnoea and hypoxia, and was found to have new-onset severe pulmonary hypertension (PH) by right heart catheterisation. A diagnosis of pulmonary tumour thrombotic microangiopathy (PTTM) was made at autopsy. PTTM is a rare complication of advanced cancer that often presents as rapidly progressive PH or acute hypoxic respiratory failure. Widespread tumour cell emboli in the pulmonary arteries and arterioles are hypothesised to induce fibrocellular subintimal proliferation and microthrombi, leading to increased pulmonary vascular resistance and PH. PTTM arising from serous ovarian cancer is exceedingly rare, with only two previously reported cases. A discussion of the pathophysiology, diagnosis and management of PTTM is presented.

publication date

  • August 26, 2015

Research

keywords

  • Cystadenocarcinoma, Serous
  • Hypertension, Pulmonary
  • Lung Neoplasms
  • Neoplasms, Glandular and Epithelial
  • Neoplastic Cells, Circulating
  • Ovarian Neoplasms
  • Pulmonary Embolism
  • Thrombotic Microangiopathies

Identity

PubMed Central ID

  • PMC4551019

Scopus Document Identifier

  • 84941213613

Digital Object Identifier (DOI)

  • 10.2169/internalmedicine.52.0718

PubMed ID

  • 26311016

Additional Document Info

volume

  • 2015