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Abstract

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Article in Japanese

Case Report

A case of pulmonary tumor thrombotic microangiopathy caused by ovarian cancer

Wataru Yamaguchi  Junya Nakaya  Toru Kojima  Keiichiro Takase 

Department of Respiratory Medicine, Fukui Prefectural Hospital

ABSTRACT

A 59-year-old woman was admitted to our hospital because of general fatigue and dyspnea. She suffered hypoxia and right heart failure because of pulmonary hypertension. However, a chest contrast-enhanced computed tomography (CT) showed no thrombus in pulmonary artery, but abdominal CT revealed intrapelvic tumors. Within a 5-h duration, she died of cardiopulmonary arrest resulting from rapid progression of respiratory and right heart failure. An autopsy revealed ovarian cancer and widespread tumor embolisms, along with fibrocellular intimal proliferation and thrombus formation in pulmonary arterioles. No tumor cells were detected in any other organs; thus we thought the primary tumor was most likely ovarian cancer, and the patient was diagnosed as having pulmonary tumor thrombotic microangiopathy (PTTM) caused by ovarian cancer. As in this case, if we have a patient with pulmonary hypertension and no embolism in the proximal pulmonary arteries on the enhanced CT, we should consider PTTM as the differential diagnosis.

KEYWORDS

Acute respiratory failure  Pulmonary tumor embolism  Pulmonary tumor thrombotic microangiopathy (PTTM)  Ovarian cancer 

Received 25 Jul 2011 / Accepted 7 Dec 2011

AJRS, 1(3): 231-236, 2012

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