Key result
A 68-year-old woman with a history of breast cancer developed rapidly progressive respiratory failure due to pulmonary tumor thrombotic microangiopathy and died 4 days after admission.
Case Report (n=1)
No
Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare but fatal cause of rapidly progressive right heart failure and respiratory failure in cancer patients, requiring early consideration and diagnosis.
PTTM warrants consideration in cancer patients with acute right heart failure; single case leaves open diagnostic and therapeutic strategies.
症例は68歳，女性．右乳癌（T2N0M0 Stage IIA）に対し右乳房部分切除を施行した．術後7年目に突然の労作時呼吸困難が出現，徐々に症状は進行し体動困難となったため当院を受診した．胸部造影CTで明らかな器質的疾患はみられなかった．心エコーで右心負荷所見を認め，肺血流シンチグラフィーで両側肺末梢に多発性楔状欠損が認められた．肺動脈吸引細胞診では異型細胞を認め，病歴，臨床症状，細胞診より乳癌再発に伴う，pulmonary tumor thrombotic microangiopathy（以下PTTM）と診断した．抗凝固療法，呼吸循環管理を継続するも急激に全身状態が悪化し，入院後4日目に永眠した．PTTMは急速に呼吸不全が進行する，予後不良な病態である．担癌患者に発症した突然の呼吸困難，右心不全に対しては，本疾患も念頭に置き早期の診断確定，治療介入が望まれる．
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Baba et al. (2021) conducted a case report in Pulmonary tumor thrombotic microangiopathy (PTTM) associated with recurrent breast cancer (n=1). Pulmonary tumor thrombotic microangiopathy (PTTM) was evaluated on Clinical course and survival. A 68-year-old woman with a history of breast cancer developed rapidly progressive respiratory failure due to pulmonary tumor thrombotic microangiopathy and died 4 days after admission.
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