Edit concept Question Editor Create issue ticket

Pulmonary Tumor Embolism

Arterial Embolism Pulmonary Tumor


Presentation

  • Pulmonary tumor embolism as a presenting feature of hepatocellular carcinoma is rare. It has been reported only once previously. In that case, other signs and symptoms of liver disease were present.[ncbi.nlm.nih.gov]
Hypothermia
  • Emergency cardiopulmonary bypass was commenced under profound hypothermia and cardiac arrest.[ncbi.nlm.nih.gov]
Falling
  • Despite this, the choriocarcinoma responded very well to the chemotherapeutic agent initiated, and the patient under VA ECMO responded positively, with serum beta hCG falling to within the normal levels.[e-crt.org]
Dyspnea
  • However, he was sent to emergency room (ER) one month later due to dyspnea where pulmonary hypertension was discovered by repeated echocardiography.[ncbi.nlm.nih.gov]
Chest Pain
  • We describe a patient who presented with chest pain and sudden shortness of breath. Autopsy disclosed diffuse pulmonary microembolism to septal capillaries caused by tumor cells from a squamous cell carcinoma of the cervix.[ncbi.nlm.nih.gov]
  • Patients typically present with dyspnea and pleuritic chest pain and signs of cor pulmonale that develop over weeks to months.[merckmanuals.com]
  • If you do have symptoms, they can include shortness of breath, chest pain or coughing up blood. Symptoms of a blood clot include warmth, swelling, pain, tenderness and redness of the leg.[icdlist.com]
  • These patients can present with shortness of breath, dyspnea on exertion, pleuritic chest pain, cough, general malaise, and palpitations. Therefore, it can often be very difficult to discern the two diagnoses.[cancertherapyadvisor.com]
  • Case Report An 82-year-old woman presented with a two-month history of worsening left chest pain and dyspnea on exertion. She also had a dry, non-productive cough.[bioline.org.br]
Leg Pain
  • Further history elicited mention of persistent right leg pain since two weeks after a long road trip. Subsequent spiral CT chest demonstrated extensive bilateral pulmonary emboli.[shmabstracts.com]
Myalgia
  • The patient described a cough, palpitation, and generalized myalgia. The patient had no prior medical history. She denied the use of tobacco products and said she consumed alcohol only occasionally.[e-crt.org]
Amnesia
  • The patient recovered with slight retrograde amnesia. A postoperative pulmonary perfusion scintigram showed no defect in the pulmonary circulation. She is well now 8 months after surgery.[ncbi.nlm.nih.gov]

Workup

  • To perform diagnostic workup and therapeutic interventions, such as embolectomy and pulmonary angiogram, ECMO is essential to maintain hemodynamic stability.[e-crt.org]
  • Because of the routine use of US and beta-hCG in the workup of early gestational abnormalities, complete molar pregnancy rarely presents with the traditional signs.[clinicaladvisor.com]
Pericardial Effusion
  • A 72-year-old man with a large mass in the right atrium and the pulmonary embolism by chest computed tomography was diagnosed as the primary cardiac B-cell lymphoma (PCL) with pulmonary tumor embolism and pericardial effusion.[ncbi.nlm.nih.gov]
Ventricular Hypertrophy
  • Morphologically, however, right ventricular hypertrophy-dilatation, histological signs of pulmonary hypertension, and hemorrhagic infarcts were more prevalent in the cases with arterial tumor embolism.[ncbi.nlm.nih.gov]
  • Deaths are attributed, in part, by the progression to cor pulmonale which is defined by the presence of right ventricular dilation from pulmonary hypertension in either the presence or absence of right ventricular hypertrophy [ 6 ].[wjso.biomedcentral.com]
Liver Biopsy
  • Finally, he died of hepatic failure from Paget’s disease hepatic involvement confirmed by liver biopsy at 10 months after recurrence.[jsms.sch.ac.kr]

Treatment

  • Currently, diagnosis of DMPTE is challenging and treatment is limited although advances of modern medicine.[ncbi.nlm.nih.gov]
  • With regard to treatment, urgent thrombolysis or surgical approach is mandatory; however, these treatments might be limited because of refractory hypoxia and shock.[e-crt.org]
  • He was given IV solumedrol and nebulizer treatments but did not improve however. Further history elicited mention of persistent right leg pain since two weeks after a long road trip.[shmabstracts.com]

Prognosis

  • Because the prognosis and treatment differ from that of thrombotic pulmonary emboli, the differentiating imaging characteristics of intravascular tumor embolism are reviewed.[ncbi.nlm.nih.gov]
  • The prognosis is poor and the median survival from diagnosis is a few weeks. Interventions are rarely performed.[scitechnol.com]
  • Most of patients with EMPD have a good prognosis, but invasive EMPD with regional metastasis has a poor prognosis [ 2 ]. A few cases show aggressive manifestations of EMPD with systemic metastasis [ 2 ].[jsms.sch.ac.kr]
  • Tumor embolism The prognosis is poor; median survival from diagnosis is only a few weeks. Particulate/foreign material The prognosis varies widely: for patients with mercury emboli, the prognosis is good, although death has been reported.[clinicaladvisor.com]
  • Conclusion Hepatocellular carcinoma with extension into hepatic and inferior vena cava has usually poor prognosis especially in patient with advanced Okuda staging.[ispub.com]

Etiology

  • Keywords Adenocarcinoma/blood/secondary — Autopsy — Breast Neoplasms/pathology — Diagnosis, Differential — Dyspnea/diagnosis/etiology — Fatal Outcome — Female — Fibrin Fibrinogen Degradation Products/metabolism — Heart Failure/blood/etiology — Humans[archive-ouverte.unige.ch]
  • Fat Embolism Fat embolism syndrome (FES) is extensively debated in the literature, concerning etiology, risk, pathophysiology, diagnosis and treatment. FES is a phenomenon secondary to fat embolism.[jbsr.be]
  • Cerebral ischemia has several major etiologies, including atherosclerosis, cardiogenic emboli, vasculitis, increased blood viscosity and carotid dissection [ 11 ].[intjem.springeropen.com]

Epidemiology

  • The increasing use of catheters and prosthetic vascular devices and increasing numbers of immunocompromised patients have changed the epidemiology. It is now an uncommon complication of IV drug use, presumably because of improved hygiene.[clinicaladvisor.com]
  • The epidemiology of venous thromboembolism. Circulation 2003;107:I4-8. The Surgeon General's Call to Action to Prevent Deep Vein Thrombosis and Pulmonary Embolism. Rockville (MD), 2008. Hoeper MM. Chronic thromboembolic pulmonary hypertension.[acc.org]
Sex distribution
Age distribution

Pathophysiology

  • A discussion of the pathophysiology, diagnosis and management of PTTM is presented.[casereports.bmj.com]
  • Pathophysiology TE can develop from several mechanisms. Pulmonary artery embolism may occur but lymphatic invasion with mediastinal and pulmonary lymphatic extension is more common [ 21 ].[wjso.biomedcentral.com]
  • Tochigi N, Wakayama M, Shinozaki M, Nakayama H, Ishiwatari T, Shimodaira K, Nemoto T, Ohno H, Kaneko Y, Makimura K, Uchida K, Miyazaki Y, Yamaguchi H, Shibuya K 雑誌名 Mediators Inflamm 巻 : 2013(online journal) ページ : 465319-465319 DOI 関連する報告書 査読あり [雑誌論文] Pathophysiological[kaken.nii.ac.jp]
  • The clinicopathological syndrome of subacute cor pulmonale caused by tumor microemboli to the pulmonary vasculature is exceedingly rare, and details of its pathophysiology are sparse.[blogs.nejm.org]
  • The pathophysiological mechanisms underlying the development of pulmonary hypertension secondarily to tumour emboli in lungs is largely unknown, but two hypotheses have been described.[tidsskriftet.no]

Prevention

  • When tumor thrombosis has been detected or suspected, hepatic vascular exclusion should be considered for the prevention of intraoperative embolism.[ncbi.nlm.nih.gov]
  • Immediate delivery of fetus by C-section is mandatory to prevent fetal hypoxic damage and facilitate resuscitation.[clinicaladvisor.com]
  • To prevent compartment syndrome by revascularization, additional mini-fasciotomy on the right lower extremity was performed.[kjccm.org]
  • Early splinting of fractures of long bones and operative rather than external fixation are thought to help prevent fat embolism.[merckmanuals.com]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!