Long-term survival of a patient with uterine cancer-induced pulmonary tumor thrombotic microangiopathy following treatment with platinum-based chemotherapy and bevacizumab: A case report

Abstract

Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare but fatal cancer-related disease. Owing to its non-specific findings, aggressive course, and lack of established treatment guidelines, only a few cases of antemortem diagnosis in long-term survivors have been reported. We aimed to report a case of uterine cervical cancer induced PTTM that was suspected based on pulmonary hypertension and successfully treated using combination chemotherapy despite of delayed diagnose. It is important to be aware that PTTM should be suspected when respiratory failure occurs in patients with unexplained pulmonary hypertension. Multidisciplinary treatments including molecular targeted therapies might be effective treatment options.

Keywords: BAL, bronchoalveolar lavage; Bevacizumab; CT, computed tomography; Case report; EBUS-TBLB, endobronchial ultrasound-guided transbronchial lung biopsy; FDG, fluorodeoxyglucose (18F); GGO, ground glass opacity; PAP, pulmonary arterial pressure; PAWP, pulmonary arterial wedge pressure; PDGF, platelet-derived growth factor; PET–CT, positron emission tomography–computed tomography; PTTM, pulmonary tumor thrombotic microangiopathy; Pulmonary hypertension; Pulmonary tumor thrombotic microangiopathy; VEGF, vascular endothelial growth factor; Vascular endothelial growth factor.