Pulmonary tumor thrombotic microangiopathy and pulmonary veno-occlusive disease in a woman with cervical cancer treated with cediranib and durvalumab

Suffredini, Dante A.; Lee, Jungmin; Peer, Cody J.; Pratt, Drew; Kleiner, David E.; Elinoff, Jason M.; Solomon, Michael A.

doi:10.1186/s12890-018-0681-x

Cited by 11 publications

(8 citation statements)

References 26 publications

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“…In recent years, with the promotion of cytological screening, more potential CC patients have been diagnosed; on the other hand, with the improvement of modern medical technology, the treatment methods of CC continue to improve, and the mortality rate of patients has decreased significantly, but some CC patients still have distant metastasis, and the lung is the main organ of distant metastasis. [ 7 , 8 , 9 , 10 , 11 ] The incidence of lung metastasis in CC was 2.1% to 6.1% reported in previous literature. Lung metastasis seriously affected the survival rate and prognosis of CC patients.…”

Section: Discussionmentioning

confidence: 99%

Analysis of related risk factors of lung metastasis after laparoscopic radical hysterectomy of cervical cancer

Henglian

Wang

et al. 2021

Medicine

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To explore the risk factors of lung metastasis in patients after laparoscopic radical hysterectomy (LRH) of cervical cancer (CC). The clinical data of CC patients with clinical stage of IA 1 –IIA 2 diagnosed in our hospital from April 2007 to October 2015 were collected. According to the situation of metastasis, the patients were divided into lung metastasis (n = 73) and non-lung metastasis group (n = 2076). The clinical data were compared between 2 groups, and logistic stepwise regression model was used to analyze the risk factors of lung metastasis in patients with CC after LRH. The incidence of lung metastasis after LRH of CC was 3.39%, and 67.13% of patients with lung metastases had no obvious clinical symptoms. 15.06% patients had lung metastasis in the first year, 38.35% in the second year, 43.83% in the third year and later. The postoperative lung metastasis of CC was related to tumor diameter ( P < .001), pathological type ( P < .001), interstitial invasion depth ( P < .001), pelvic lymph node metastasis (PLNM, P < .001), vascular tumor thrombus ( P = .011), tumor uterine invasion ( P = .002), and abnormal preoperative tumor markers ( P = .015). However, it was not related to age, clinical stage, tumor growth pattern, tumor differentiation, and para-aortic lymph node metastasis ( P > .05). Logistic regression analysis revealed non-squamous cell carcinoma ( P = .022), tumor diameter ≥4 cm ( P = .008), interstitial invasion depth >2/3 ( P = .003), PLNM ( P = .007), and tumor uterine invasion ( P = .037) is an independent risk factor for lung metastasis after LRH of CC. Non-squamous cell carcinoma, tumor diameter ≥4 cm, tumor interstitial invasion depth >2/3, PLNM, and tumor uterine invasion are independent risk factors for lung metastasis after LRH of CC.

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Section: Discussionmentioning

confidence: 99%

Analysis of related risk factors of lung metastasis after laparoscopic radical hysterectomy of cervical cancer

Henglian

Wang

et al. 2021

Medicine

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“…[ 9 ] did not find a case related to cervical cancer. However, there have been two cases reported in 2018,[ 13 14 ] one of which is purported to be the first case. [ 13 ] However, a similar case has been reported as early as 1971, but had highlighted certain other characteristics.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary microvascular metastases in cervical carcinoma

Vaideeswar

Aswani

Damani

et al. 2020

Journal of Postgraduate Medicine

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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.

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“…Pulmonary tumor thrombotic microangiopathy is excluded from this study. Pulmonary tumor thrombotic microangiopathy is a related but different entity from pulmonary tumor embolism and is characterized by microscopic tumor cell emboli in the pulmonary microvasculature causing intimal proliferation and a syndrome of hypoxemia, pulmonary hypertension, right heart failure and death [ 6 ].…”

Section: Methodsmentioning

confidence: 99%

Pulmonary tumor embolism: A retrospective study over a 30-year period

Anthony

Catoni

et al. 2021

PLoS ONE

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Background Pulmonary tumor embolism (PTE) is difficult to detect before death, and it is unclear whether the discrepancy between antemortem clinical and postmortem diagnosis improves with the advance of the diagnostic technologies. In this study we determined the incidence of PTE and analyzed the discrepancy between antemortem clinical and postmortem diagnosis. Methods We performed a retrospective autopsy study on patients with the history of malignant solid tumors from 1990 to 2020 and reviewed all the slides of the patients with PTE. We also analyzed the discrepancies between antemortem clinical and postmortem diagnosis in 1999, 2009 and 2019 by using the Goldman criteria. Goldman category major 1 refers to cases in which an autopsy diagnosis was the direct cause of death and was not recognized clinically, but if it had been recognized, it may have changed treatment or prolonged survival. Results We found 20 (3%) cases with PTE out of the 658 autopsy cases with solid malignancies. Out of these 20 cases, urothelial carcinoma (30%, 6/20) and invasive ductal carcinoma of the breast (4/20, 20%) were the most common primary malignancies. Seven patients with shortness of breath died within 3–17 days (average 8.4±2.2 days) after onset of the symptoms. Pulmonary embolism was clinically suspected in seven out of twenty (35%, 7/20) patients before death, but only two patients (10, 2/20) were diagnosed by imaging studies before death. The rate of Goldman category major 1 was 13.2% (10/76) in 1999, 7.3% (4/55) in 2009 and 6.9% (8/116) in 2019. Although the rate of Goldman category major 1 appeared decreasing, the difference was not statistically significant. The autopsy rate was significantly higher in 2019 (8.4%, 116/1386) than in 2009 (4.4%, 55/1240). Conclusions The incidence of PTE is uncommon. Despite the advances of the radiological techniques, radiological imaging studies did not detect the majority of PTEs. The discrepancy between the antemortem clinical and the postmortem diagnosis has not improved significantly over the past 30 years, emphasizing the value of autopsy.

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Pulmonary tumor thrombotic microangiopathy and pulmonary veno-occlusive disease in a woman with cervical cancer treated with cediranib and durvalumab

Cited by 11 publications

References 26 publications

Analysis of related risk factors of lung metastasis after laparoscopic radical hysterectomy of cervical cancer

Analysis of related risk factors of lung metastasis after laparoscopic radical hysterectomy of cervical cancer

Pulmonary microvascular metastases in cervical carcinoma

Pulmonary tumor embolism: A retrospective study over a 30-year period

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