Key result
Chemotherapy fails to prevent fatal pulmonary tumor embolism despite controlling transitional cell carcinoma liver metastases.
Case Report (n=1)
Transitional cell carcinoma can cause fatal diffuse microscopic pulmonary tumor embolism presenting as respiratory failure with normal chest CT, even when liver metastases are controlled.
May cause fatal respiratory failure from microscopic pulmonary tumor embolism despite controlled metastases and normal CT; single case leaves open incidence and screening needs.
Clinicians generally suspect pulmonary tumor embolism (PTE) with uncontrolled carcinomas which often spread to lungs. We, however, experienced an autopsy case of diffuse microscopic PTE despite controlled liver metastases of transitional cell carcinoma (TCC). A 66-year-old man with progressing respiratory symptoms showed almost normal chest findings on computed tomography. Although liver metastases were successfully shrunk by chemotherapy, the patient died from aggressive respiratory failure. An autopsy revealed small pulmonary vessels showing diffuse tumor emboli. TCC can cause PTE even if liver metastases are controlled. We must therefore be aware that PTE can manifest as respiratory symptoms without any computed tomography findings.
No takes yet. Share an insight, caveat, or question.
Kitayama et al. (2016) conducted a case report in Transitional cell carcinoma with liver metastases and pulmonary tumor embolism (n=1). Transitional cell carcinoma with liver metastases was evaluated. An autopsy revealed that a 66-year-old man with transitional cell carcinoma developed fatal diffuse microscopic pulmonary tumor embolism despite his liver metastases being well controlled by chemotherapy.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: