Acute cor pulmonale due to pulmonary tumour thrombotic microangiopathy from renal cell carcinoma

Maria Story; Sook Kyung Kwon; Robert Robinson; Spyridon Fortis

doi:10.1136/bcr-2017-219730

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Acute cor pulmonale due to pulmonary tumour thrombotic microangiopathy from renal cell carcinoma

Journal article

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Acute cor pulmonale due to pulmonary tumour thrombotic microangiopathy from renal cell carcinoma

Maria Story, Sook Kyung Kwon, Robert Robinson and Spyridon Fortis

BMJ case reports, Vol.2017, p.bcr-2017-219730

06/28/2017

DOI: 10.1136/bcr-2017-219730

PMCID: PMC5534775

PMID: 28659364

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Abstract

We report the case of a previously healthy man who presented with subacute dyspnoea after a long drive. He developed hypoxic respiratory failure, thought secondary to a massive pulmonary embolism and was treated with tissue plasminogen activator but died in the hospital despite aggressive medical measures. Autopsy revealed pulmonary tumour thrombotic microangiopathy (PTTM) from papillary renal cell carcinoma. PTTM is a rare clinicopathological syndrome that clinically results in symptoms of dyspnoea and right heart failure. Pathologically, a localised paraneoplastic process evolves from tumour microemboli in the pulmonary arterioles, resulting in fibrocellular proliferation and narrowing of the vessels, causing subacute right heart failure. To our knowledge, this is the first case of PTTM due to papillary renal cell carcinoma.

Details

Title: Subtitle: Acute cor pulmonale due to pulmonary tumour thrombotic microangiopathy from renal cell carcinoma
Creators: Maria Story - Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
Sook Kyung Kwon - Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
Robert Robinson - Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
Spyridon Fortis - Pulmonary, Critical Care and Occupational Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
Resource Type: Journal article
Publication Details: BMJ case reports, Vol.2017, p.bcr-2017-219730
DOI: 10.1136/bcr-2017-219730
PMID: 28659364
PMCID: PMC5534775
NLM abbreviation: BMJ Case Rep
ISSN: 1757-790X
eISSN: 1757-790X
Language: English
Date published: 06/28/2017
Academic Unit: Physician Assistant Studies; Pulmonary, Critical Care, and Occupational Medicine; Oral Pathology, Radiology and Medicine; Pathology; Internal Medicine
Record Identifier: 9984047679702771

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