Key result
Occult gastric carcinoma presents as cor pulmonale from ~50% pulmonary microvascular occlusion by tumor microemboli.
Why the study?
Cor pulmonale due to tumor cell microemboli as the initial and terminal manifestation of clinically occult gastric carcinoma is rare and not well characterized.
Case Report (n=1)
Highlights a rare case where cor pulmonale due to tumor cell microemboli was the initial and terminal manifestation of occult gastric carcinoma.
Consider occult gastric carcinoma in unexplained cor pulmonale; leaves open prevalence and diagnostic implications of tumor microemboli.
Progressive dyspnea developed in a 36-year-old woman. Physical examination and chest roentgenogram showed the signs of pulmonary hypertension. She died of respiratory failure in spite of treatment. Autopsy disclosed gastric carcinoma in the pylorus with metastases to the regional lymph nodes, left adrenal gland, and ovaries. There were no gross pulmonary emboli, but more than 50% of pulmonary microvasculature was occluded by tumor cell microemboli. No parenchymal metastases were found in the lung. This case was remarkable because cor pulmonale due to tumor cell microemboli to the lung was the initial and terminal manifestation of clinically occult, but pathologically advanced, gastric carcinoma.
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Kazuhito Hirata (1988) conducted a case report in Cor pulmonale due to tumor cell microemboli (n=1). Tumor cell microemboli from gastric carcinoma was evaluated on Cor pulmonale and respiratory failure. Clinically occult but pathologically advanced gastric carcinoma presented initially and terminally as cor pulmonale due to tumor cell microemboli occluding over 50% of the pulmonary microvasculature.
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