Key result
Early transbronchial biopsy and prompt chemotherapy yield 9-month survival in pulmonary tumor thrombotic microangiopathy.
Why the study?
Pulmonary tumor thrombotic microangiopathy is an acute, progressive, and fatal disease causing pulmonary hypertension and right heart failure, where antemortem diagnosis is very difficult to obtain.
Case Report (n=1)
No
Early diagnosis of PTTM via transbronchial lung biopsy and subsequent chemotherapy with angiogenesis inhibitors may enable long-term survival in an otherwise rapidly fatal disease.
Supports transbronchial biopsy for PTTM diagnosis; hypothesis-generating and requires prospective validation.
Pulmonary tumor thrombotic microangiopathy (PTTM) is an acute, progressive, and fatal disease. PTTM manifests as subacute respiratory failure with pulmonary hypertension, progressive right-sided heart failure, and sudden death. An antemortem diagnosis of PTTM is very difficult to obtain, and many patients die within several weeks. We herein report a case of PTTM diagnosed based on a transbronchial lung biopsy. In this case, we finally diagnosed PTTM due to gastric cancer because of its histological identity. The patient was administered chemotherapy, including angiogenesis inhibitors, against gastric cancer at an early age and survived for a long time.
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Imakura et al. (2020) conducted a case report in Pulmonary tumor thrombotic microangiopathy (PTTM) due to gastric cancer (n=1). Chemotherapy (including S-1, oxaliplatin, docetaxel, nab-paclitaxel, ramucirumab, irinotecan) was evaluated on Survival after diagnosis. Early diagnosis of pulmonary tumor thrombotic microangiopathy via transbronchial lung biopsy and prompt initiation of chemotherapy enabled a 68-year-old man to survive for 9.0 months.
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