The diagnostic challenge in pulmonary tumour embolism in cancer: a case report and literature review

Pulmonary tumour embolism is a rare condition without specific symptoms or pathognomonic features. Pulmonary tumour embolism can occur as the first manifestation of cancer, but because of diagnostic difficulties, it is often wrongly recognised as a more common cardiopulmonary disease. We present a c...

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Published inContemporary oncology (Poznan, Poland) Vol. 24; no. 4; pp. 258 - 262
Main Authors Zielińska, Aleksandra, Braun, Marcin, Piasecka, Dominika, Minc, Piotr, Romańska, Hanna M
Format Journal Article
LanguageEnglish
Published Poland Termedia Publishing House 01.01.2020
Subjects
Biopsy
Cancer therapies
Case Report
Chemotherapy
Cytokeratin
Disease
Dyspnea
dyspnoea
Embolisms
Literature reviews
Pathology
Patients
Pleural effusion
Prostate
Pulmonary hypertension
pulmonary tumour embolism
Sarcoidosis
signet-ring gastric adenocarcinoma
pulmonary tumour embolism
pleural effusion
dyspnoea
signet-ring gastric adenocarcinoma
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Summary:Pulmonary tumour embolism is a rare condition without specific symptoms or pathognomonic features. Pulmonary tumour embolism can occur as the first manifestation of cancer, but because of diagnostic difficulties, it is often wrongly recognised as a more common cardiopulmonary disease. We present a case of a 46-year-old Caucasian male with no prior malignancy diagnosis, admitted because of progressing dyspnoea and cough. Based on radiological and clinical presentations, sarcoidosis, silicosis and lymphangitic carcinomatosis were considered in the differential diagnosis. Histopathological analysis of lung biopsy revealed that multiple emboli of atypical epithelial cells found in the pulmonary vessels were of gastrointestinal origin. Further pathological examination of the gastric biopsy led to the final diagnosis of the signet-ring cells gastric adenocarcinoma. The patient was referred for chemotherapy. After a short-term partial remission, he died within two months after the final diagnosis. The presented case illustrates challenges posed by the diagnostic process of pulmonary tumour embolism.
ISSN:1428-2526
1897-4309
DOI:10.5114/wo.2020.102631