Pulmonary Tumor Thrombotic Microangiopathy

• Published in: JACC. Case reports Vol. 30; no. 5; p. 103194
• Main Authors: Ali, Hyeon-Ju, Cui, Shengjie, Sahay, Sandeep, Grosu, Horiana B., Riben, Michael W., Deswal, Anita, Mouhayar, Elie, Iliescu, Cezar, Ali, Abdelrahman, Faiz, Saadia A.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 05.03.2025
• Subjects: cancer; Cardiovascular; metastatic adenocarcinoma; pulmonary hypertension; right ventricular failure; CT; pulmonary hypertension; metastatic adenocarcinoma; FDG; PH; PTTM; cancer; CTEPH; right ventricular failure; RHC; PET; PVOD; computed tomography; fludeoxyglucose-19; right-sided heart catheterization; chronic thromboembolic pulmonary hypertension; pulmonary veno-occlusive disease; pulmonary tumor thrombotic microangiopathy; positron emission tomography
• ISSN: 2666-0849; 2666-0849
• DOI: 10.1016/j.jaccas.2024.103194

Pulmonary hypertension in patients with advanced solid organ tumors may be secondary to a rare diagnosis of pulmonary tumor thrombotic microangiopathy. Current literature is limited to case reports, and there is no consensus on diagnosis and management. This case highlights the importance of a high degree of clinical suspicion and the role of additional work-up for pulmonary tumor thrombotic microangiopathy including fludeoxyglucose-19–positron emission tomography and cytology of pulmonary artery blood sample at the time of right-sided heart catheterization. Future studies are needed to better understand the role of pulmonary vasodilators and targeted therapies, such as platelet-derived growth factor inhibitors, and their impact on the clinical outcomes for patients with poor prognosis secondary to their cancers. [Display omitted]