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[Pulmonary microscopic tumor embolism syndrome].

I Bergmann1, M Weiss, T Schaffner

  • 1Klinik und Poliklinik für Allgemeine Innere Medizin, Universitätsspital Bern, Schweiz. ivo.bergmann@insel.ch

Deutsche Medizinische Wochenschrift (1946)
|March 18, 2006
PubMed
Summary

Microscopic pulmonary tumor embolism, a rare cause of right heart failure in cancer patients, should be considered when other causes are excluded. Autopsies revealed angiosis carcinomatosa in fatal cases.

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Area of Science:

  • Oncology
  • Pathology
  • Cardiology

Background:

  • Malignant neoplasms can present with cardiorespiratory symptoms.
  • Adenocarcinomas, particularly, may lead to complex clinical presentations.

Observation:

  • Two patients with advanced adenocarcinoma (colon and prostate) developed unexplained dyspnea and right heart failure.
  • Echocardiography revealed severe pulmonary hypertension and right ventricular dilatation.
  • CT scans excluded pulmonary embolism, a common cause of these symptoms.

Findings:

  • Autopsies confirmed extensive metastatic adenocarcinoma with angiosis carcinomatosa in the lungs, causing arterial occlusion and cor pulmonale.
  • Microscopic tumor embolism was identified as the cause of pulmonary hypertension and heart failure.

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  • Thrombotic pulmonary embolism was definitively ruled out in both cases.

    • Implications:

    • Microscopic pulmonary tumor embolism is a critical differential diagnosis in cancer patients with unexplained dyspnea and pulmonary hypertension.
    • Cytologic examination of pulmonary artery blood may aid in diagnosing angiosis carcinomatosa.
    • Early consideration of this rare condition can improve diagnostic accuracy in complex cases.