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Pulmonary tumor thrombotic microangiopathy of patient with both hepatocellular carcinoma and gastric signet-ring cell carcinoma: a case report and review of literature

Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare cancer-related complication characterized by intimal proliferation in the pulmonary small arteries with or without tumor emboli, which can be fatal due to progressive pulmonary hypertension (PH). And PTTM is hard to be confirmed during life...

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Autores principales: Shen, Lulei, Yang, Li, Jiang, Hanshui, Mo, Ting, Fan, Mengdi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8797640/
https://www.ncbi.nlm.nih.gov/pubmed/35116515
http://dx.doi.org/10.21037/tcr-20-3107
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author Shen, Lulei
Yang, Li
Jiang, Hanshui
Mo, Ting
Fan, Mengdi
author_facet Shen, Lulei
Yang, Li
Jiang, Hanshui
Mo, Ting
Fan, Mengdi
author_sort Shen, Lulei
collection PubMed
description Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare cancer-related complication characterized by intimal proliferation in the pulmonary small arteries with or without tumor emboli, which can be fatal due to progressive pulmonary hypertension (PH). And PTTM is hard to be confirmed during lifetime; hence, it is vital to pay more attention to high-risk PTTM, which may progress quickly. PTTM patients have an extremely poor prognosis. Here, we have reported a case of a patient with both hepatocellular carcinoma (HCC) and gastric signet-ring cell carcinoma who presented with dyspnea and died rapidly and was diagnosed with suspected PTTM. In addition, we have reviewed some related literature. This patient showed a poorer prognosis, with a survival time of only 3 days after oxygen supplementation (very poor compared to the average level of PTTM patients caused by gastric carcinoma only, which was 18 days according to our summary). Besides, respiratory discomfort is the main symptom of PTTM. Abnormal pulmonary imaging was reported with the appearance of septal thickening, ground-glass opacities, small nodules, pleural effusion, and a tree-in-bud pattern in PTTM patients. No effective therapeutic options have been established for PTTM. PTTM should be considered in patients with cancer who progress to rapid respiratory failure and PH, especially in patients with multiple tumors whose condition is more likely to deteriorate quickly.
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spelling pubmed-87976402022-02-02 Pulmonary tumor thrombotic microangiopathy of patient with both hepatocellular carcinoma and gastric signet-ring cell carcinoma: a case report and review of literature Shen, Lulei Yang, Li Jiang, Hanshui Mo, Ting Fan, Mengdi Transl Cancer Res Case Report Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare cancer-related complication characterized by intimal proliferation in the pulmonary small arteries with or without tumor emboli, which can be fatal due to progressive pulmonary hypertension (PH). And PTTM is hard to be confirmed during lifetime; hence, it is vital to pay more attention to high-risk PTTM, which may progress quickly. PTTM patients have an extremely poor prognosis. Here, we have reported a case of a patient with both hepatocellular carcinoma (HCC) and gastric signet-ring cell carcinoma who presented with dyspnea and died rapidly and was diagnosed with suspected PTTM. In addition, we have reviewed some related literature. This patient showed a poorer prognosis, with a survival time of only 3 days after oxygen supplementation (very poor compared to the average level of PTTM patients caused by gastric carcinoma only, which was 18 days according to our summary). Besides, respiratory discomfort is the main symptom of PTTM. Abnormal pulmonary imaging was reported with the appearance of septal thickening, ground-glass opacities, small nodules, pleural effusion, and a tree-in-bud pattern in PTTM patients. No effective therapeutic options have been established for PTTM. PTTM should be considered in patients with cancer who progress to rapid respiratory failure and PH, especially in patients with multiple tumors whose condition is more likely to deteriorate quickly. AME Publishing Company 2021-04 /pmc/articles/PMC8797640/ /pubmed/35116515 http://dx.doi.org/10.21037/tcr-20-3107 Text en 2021 Translational Cancer Research. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.
spellingShingle Case Report
Shen, Lulei
Yang, Li
Jiang, Hanshui
Mo, Ting
Fan, Mengdi
Pulmonary tumor thrombotic microangiopathy of patient with both hepatocellular carcinoma and gastric signet-ring cell carcinoma: a case report and review of literature
title Pulmonary tumor thrombotic microangiopathy of patient with both hepatocellular carcinoma and gastric signet-ring cell carcinoma: a case report and review of literature
title_full Pulmonary tumor thrombotic microangiopathy of patient with both hepatocellular carcinoma and gastric signet-ring cell carcinoma: a case report and review of literature
title_fullStr Pulmonary tumor thrombotic microangiopathy of patient with both hepatocellular carcinoma and gastric signet-ring cell carcinoma: a case report and review of literature
title_full_unstemmed Pulmonary tumor thrombotic microangiopathy of patient with both hepatocellular carcinoma and gastric signet-ring cell carcinoma: a case report and review of literature
title_short Pulmonary tumor thrombotic microangiopathy of patient with both hepatocellular carcinoma and gastric signet-ring cell carcinoma: a case report and review of literature
title_sort pulmonary tumor thrombotic microangiopathy of patient with both hepatocellular carcinoma and gastric signet-ring cell carcinoma: a case report and review of literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8797640/
https://www.ncbi.nlm.nih.gov/pubmed/35116515
http://dx.doi.org/10.21037/tcr-20-3107
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