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Pulmonary Tumor Thrombotic Microangiopathy Induced by Prostate Cancer

Satoshi Katayama1, Tadasu Takenaka, Aya Nakamura

  • 1Department of Urology, St.Mary's Hospital, Himeji, Hyogo 670-0801, Japan.

Acta Medica Okayama
|June 22, 2018
PubMed

Insights

Pulmonary tumor thrombotic microangiopathy (PTTM), a fatal complication of cancer, can be caused by metastatic prostate cancer. This case highlights diagnostic challenges and the need for prompt chemotherapy in PTTM patients.

Area of Science:

  • Oncology
  • Pulmonary Medicine
  • Pathology

Background:

  • Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare, fatal complication associated with malignancy.
  • It involves the microvasculature of the lungs, leading to respiratory failure.
  • PTTM is often diagnosed post-mortem due to diagnostic challenges during life.

Observation:

  • An 81-year-old man presented with dyspnea and bilateral ground-glass opacities on HRCT.
  • Pulmonary microvascular cytology identified metastatic prostate cancer cells.
  • The patient received docetaxel chemotherapy with temporary improvement.

Findings:

  • Autopsy confirmed PTTM characterized by fibrocellular intimal proliferation in small pulmonary arterioles.
  • The PTTM was directly linked to metastatic prostate cancer.
  • Pre-mortem diagnosis of PTTM and its underlying pathological changes remains difficult.

Implications:

  • This case underscores the importance of considering PTTM in cancer patients with unexplained respiratory distress.
  • Early chemotherapy may offer temporary benefits but PTTM carries a poor prognosis.
  • Further research is needed to improve pre-mortem diagnostic strategies for PTTM.
Keywords:
autopsydyspneametastatic lung cancerprostate neoplasmthrombotic microangiopathy

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