Key result
Chemotherapy with paclitaxel, carboplatin, and bevacizumab successfully improved pulmonary hypertension and respiratory symptoms in a patient with PTTM and lung adenocarcinoma.
Why the study?
Pulmonary tumor thrombotic microangiopathy is a fatal cancer-related lung complication that is difficult to diagnose and currently lacks effective treatments.
Does chemotherapy with paclitaxel, carboplatin, and bevacizumab improve pulmonary hypertension and symptoms in a patient with pulmonary tumor thrombotic microangiopathy and lung adenocarcinoma?
Case Report (n=1)
Does chemotherapy with paclitaxel, carboplatin, and bevacizumab improve pulmonary hypertension and symptoms in a patient with pulmonary tumor thrombotic microangiopathy and lung adenocarcinoma?
Aspiration cytology via right heart catheterization is useful for diagnosing PTTM, and VEGF inhibitors like bevacizumab combined with chemotherapy may be effective for treatment.
Pulmonary tumor thrombotic microangiopathy (PTTM) is a fatal cancer-related lung complication. PTTM is difficult to diagnose because of its nonspecific clinical manifestations and imaging findings. Furthermore, no effective treatments currently exist. This case report described a 57-year-old woman who was successfully diagnosed with PTTM and lung adenocarcinoma. She was admitted to our hospital for progressive dyspnea on exertion. Pulmonary artery catheterization revealed pulmonary hypertension (PH), and wedged pulmonary artery blood cell sampling disclosed histologically adenocarcinoma with TTF-1(+). We diagnosed the patient with PTTM associated with lung cancer. We started chemotherapy with paclitaxel, carboplatin, and bevacizumab. The treatment successfully improved PH, respiratory symptoms, and other outcomes. PTTM is a rare phenomenon, but it must be considered in the differential diagnosis of acute dyspnea or PH in patients with cancer. Our case report illustrates that aspiration cytology via right heart catheterization is useful for diagnosing PTTM. In addition, vascular endothelial growth factor inhibitors may be potentially effective for treating PTTM.
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Kotake et al. (2022) conducted a case report in Pulmonary tumor thrombotic microangiopathy (PTTM) and lung adenocarcinoma (n=1). Chemotherapy with paclitaxel, carboplatin, and bevacizumab was evaluated on Improvement of pulmonary hypertension and respiratory symptoms. Chemotherapy with paclitaxel, carboplatin, and bevacizumab successfully improved pulmonary hypertension and respiratory symptoms in a patient with PTTM and lung adenocarcinoma.
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