Key result
Combination chemotherapy with S-1 and cisplatin temporarily improved respiratory symptoms and chest HRCT findings in a patient with antemortem-diagnosed pulmonary tumor thrombotic microangiopathy.
Why the study?
Does combination chemotherapy improve symptoms and imaging findings in a patient with antemortem diagnosed pulmonary tumor thrombotic microangiopathy?
Case Report (n=1)
No
Does combination chemotherapy improve symptoms and imaging findings in a patient with antemortem diagnosed pulmonary tumor thrombotic microangiopathy?
Antemortem diagnosis of pulmonary tumor thrombotic microangiopathy is possible via lung biopsy, and combination chemotherapy can temporarily improve respiratory symptoms and imaging findings, though the ultimate prognosis remains poor.
Temporary benefit seen in one PTTM case; hypothesis-generating and should not change practice.
A 29-year-old man developed a persistent dry cough. Chest high-resolution computed tomography (HRCT) revealed centrilobular ultrafine granular shadows scattered in all lung fields. A lung biopsy with video-assisted thoracoscopic surgery revealed findings compatible with pulmonary tumor thrombotic microangiopathy (PTTM). However, the primary tumor was not identified. Combination chemotherapy with S-1 and cisplatin decreased his cough and improved the chest HRCT findings. The illness, however, gradually became difficult to control. He eventually developed pulmonary hypertension and died. Typically, an antemortem diagnosis of PTTM cannot be made. In this case, the diagnosis of PTTM and combination chemotherapy improved the chest HRCT findings, respiratory symptoms, and prognosis.
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Kayatani et al. (2012) conducted a case report in Pulmonary tumor thrombotic microangiopathy (PTTM) (n=1). Combination chemotherapy (S-1 and cisplatin) was evaluated on Clinical response and survival. Combination chemotherapy with S-1 and cisplatin temporarily improved respiratory symptoms and chest HRCT findings in a patient with antemortem-diagnosed pulmonary tumor thrombotic microangiopathy.
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