Key result
Two middle-aged women with pulmonary tumor thrombotic microangiopathy presented with rapidly progressive pulmonary hypertension and respiratory failure, both resulting in death.
Why the study?
Pulmonary tumor thrombotic microangiopathy is a rare, severe complication in malignancy where only a minority of patients are diagnosed ante-mortem.
Case Report (n=2)
Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare, rapidly progressive, and highly fatal complication of malignancy presenting as severe pulmonary hypertension, requiring high clinical suspicion for timely diagnosis.
Alerts clinicians to PTTM in unexplained rapid PH; leaves open strategies for earlier diagnosis and intervention.
RATIONALE: Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare but serious complication in patients with malignancy; its main manifestation includes acute pulmonary hypertension with severe respiratory distress. More than 200 cases have been reported since it was first identified in 1990. PTTM accounts for approximately 0.9% to 3.3% of deaths due to malignancy, but only a minority of patients are diagnosed ante-mortem, with most patients having a definitive diagnosis after autopsy. PATIENT CONCERNS: Two middle-aged women both died within a short period of time due to progressive dyspnea and severe pulmonary hypertension. DIAGNOSES: One patient was definitively confirmed as a gastrointestinal malignant tumor by liver puncture biopsy pathology. Ultimately, the clinical diagnosis was pulmonary tumor thrombotic microangiopathy. INTERVENTIONS: The patient was treated symptomatically with oxygen, diuresis, and anticoagulation, while a liver puncture was perfected to clarify the cause. OUTCOMES: Two cases of middle-aged female patients with rapidly progressive pulmonary hypertension and respiratory failure resulted in death with malignant neoplasm. LESSONS: PTTM has a rapid onset and a high morbidity and mortality rate. Our clinicians need to be more aware of the need for timely diagnosis through a targeted clinical approach, leading to more targeted treatment and a better prognosis.
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Ma et al. (2024) conducted a case report in Pulmonary tumor thrombotic microangiopathy (n=2). Symptomatic treatment (oxygen, diuresis, anticoagulation) was evaluated on Death. Two middle-aged women with pulmonary tumor thrombotic microangiopathy presented with rapidly progressive pulmonary hypertension and respiratory failure, both resulting in death.
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