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dc.contributorChan, E.en_US
dc.description.abstractPulmonary tumour thrombotic microangiopathy (PTTM) is a rare end stage complication of malignancy with patients presenting with progressive and worsening dyspnoea secondary to increased pulmonary vascular resistance and subsequent right heart failure. First described by Herbay PTTM is a clinicopathological diagnosis usually made post mortem, with the presence of tumour microemboli associated with fibrous intimal hyperplasia of the pulmonary vasculature. A high degree of clinical suspicion is required as the prognosis without treatment is grim, typically days to weeks. We report a 36-year-old male who presented with four days of dyspnoea on a background of recently diagnosed metastatic carcinoma of unknown primary. He was initially investigated for pulmonary embolus, however subsequent computed tomography pulmonary angiography (CTPA) showed no abnormality. Echocardiography revealed signs of acute right heart failure secondary to elevated pulmonary vascular resistance (PASP 82 mmHg, N 18–25). Despite anticoagulation, antibiotics and ICU support, the patient passed away within 24 hours of his admission. Autopsy revealed a sigmoid tumour, widespread lymphadenopathy and peritoneal deposits, with microscopy and immunohistochemistry confirming poorly differentiated colorectal adenocarcinoma within the sigmoid tumour and metastatic deposits. Atypical cells associated with thrombus and fibrous intimal hyperplasia in pulmonary vasculature confirmed PTTM as the cause of death.en_US
dc.description.provenanceSubmitted by Gemma Siemensma ( on 2019-02-25T23:31:53Z No. of bitstreams: 0en
dc.description.provenanceApproved for entry into archive by Gemma Siemensma ( on 2019-04-04T21:53:51Z (GMT) No. of bitstreams: 0en
dc.description.provenanceMade available in DSpace on 2019-04-04T21:53:51Z (GMT). No. of bitstreams: 0 Previous issue date: 2018en
dc.titlePulmonary tumour thrombotic microangiopathy in a patient with metastatic colorectal adenocarcinoma – a case report.en_US
dc.bibliographicCitation.conferencedateJune 1-3rden_US
dc.bibliographicCitation.conferencenameThe 42nd Annual Scientific Meeting of the Australasian Division of the IAP.en_US
dc.bibliographicCitation.conferenceplaceSydney, Australiaen_US
dc.subject.healththesaurusPULMONARY VASCULAR RESISTANCEen_US
dc.subject.healththesaurusRIGHT HEART FAILUREen_US
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