Pulmonary microvascular metastases in cervical carcinoma: A case series

J Postgrad Med. 2020 Jul-Sep;66(3):155-158. doi: 10.4103/jpgm.JPGM_243_20.

Abstract

Pulmonary microvascular tumor embolism (PMTE), pulmonary tumor thrombotic microangiopathy (PTTM), and lymphangitis carcinomatosis (LC) have an intricate pathophysiology and usually occur with cancers of breast, stomach, and lung. Microvascular pulmonary metastases attributable to cervical cancer are a rarity. Clinical presentation and autopsy findings of patients with microvascular pulmonary metastases in cervical cancers were studied with a review of literature. Four patients (mean age of 55.5 years) with carcinoma cervix showed microvascular metastases. Three of whom presented with respiratory symptoms, and the fourth case was unresponsive on presentation. Each patient succumbed to their illness shortly after admission. Autopsy examination performed on each patient depicted varying combination of PMTE, PTTM, and LC, all with squamous histology. This case series highlights the rare association of carcinoma cervix with the aforementioned microvascular phenomena. Besides, it underscores the sequential mechanism of occurrence of microvascular pulmonary metastasis and the associated guarded prognosis.

Keywords: cervical carcinoma; lymphangitis carcinomatosis; pulmonary microvascular tumor embolism; pulmonary tumor thrombotic microangiopathy.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / mortality
  • Adenocarcinoma / pathology
  • Adenocarcinoma / secondary*
  • Aged
  • Autopsy
  • Biomarkers, Tumor / metabolism
  • Female
  • Humans
  • Lung / blood supply*
  • Lung / pathology
  • Lung Neoplasms / blood supply
  • Lung Neoplasms / pathology
  • Lung Neoplasms / secondary*
  • Middle Aged
  • Neoplasm Metastasis
  • Neoplastic Cells, Circulating / pathology*
  • Pulmonary Artery / pathology
  • Thrombotic Microangiopathies / mortality
  • Thrombotic Microangiopathies / pathology*
  • Uterine Cervical Neoplasms / mortality
  • Uterine Cervical Neoplasms / pathology*

Substances

  • Biomarkers, Tumor