Sudden Death by Occult Metastatic Carcinoma

Dean, Stephanie; Mathis, Benjamin; Litzky, Leslie A.; Hood, Ian C.

doi:10.1111/1556-4029.12837

Cited by 6 publications

(8 citation statements)

References 10 publications

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“…Patients typically present with acute pulmonary hypertension, progressing to right-sided heart failure and sudden death, often before the actual gastric adenocarcinoma is discovered. 45 PTTM is reported to be present in 25% of patients dying of such carcinomas. However, the actual mortality associated with tumour emboli remains at 8%.…”

Section: Tumoursmentioning

confidence: 99%

Gastrointestinal causes of sudden unexpected death: A review

et al. 2017

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Gastrointestinal conditions are a less common cause of sudden unexpected death when compared to other conditions such as cardiovascular conditions, but they are equally important. Various congenital and acquired gastrointestinal conditions that have resulted in sudden unexpected death are discussed. The possible lethal mechanisms behind each condition, along with any associated risk factors or secondary diseases, have been described. Through this article, we aim to highlight the need for physicians to prevent death in such conditions by ensuring that subclinical cases are diagnosed correctly before it is too late and by providing timely and efficacious treatment to the patient concerned. In addition, this review would certainly benefit the forensic pathologist while dealing with cases of sudden unexpected death due to gastrointestinal causes. This article is a review of the major gastrointestinal causes of sudden unexpected death. In addition, related fatal cases encountered occasionally in forensic autopsy practice are also included. There are several unusual and rare causes of life-threatening gastrointestinal bleeding that may lead to sudden unexpected death to cover all the entities in detail. Nevertheless, this article is a general guide to the topic of gastrointestinal causes of sudden unexpected death.

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Section: Tumoursmentioning

confidence: 99%

Gastrointestinal causes of sudden unexpected death: A review

et al. 2017

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“…Sudden death caused by carcinoma among people without a medical history has been reported, and these were initially presented with vital organ involvement as well [19][20][21]. Future studies are needed to clarify the correlation between medical history and primary sites of sarcoma.…”

Section: Ref Ihc*mentioning

confidence: 99%

Sudden Death Due to Sarcoma: An Unusual Case and Literature Review

Wy²,

Shun³

2016

Journal of Forensic Science & Criminology

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Background: Sudden death has varied causes, and autopsy is usually required to determine cause of death. Sarcoma involvement is very infrequent, and detailed pathological evaluation is needed for correct diagnosis. When the medical history of the deceased is unavailable and autopsy is not performed, the true cause of death will not be established. Here we present an unusual case of sarcoma involving heart and lung. We also review 13 cases found in the literature with sarcoma involvement in sudden death. , which makes it more difficult to collect pertinent evidence and information. In such cases, forensic autopsy is usually performed; it is also usually required in order to gain any information. Even with autopsy, however, a small proportion of cases will not reveal a cause of death (COD). In these cases, the COD is categorized as "sudden unexplained death" [5,6]. Introduction Sudden ISSN: 2348-9804Results: The current case was a 58-year-old man found dead at home with a history of sarcoma and wide excision. The autopsy showed multiple tumors involving heart and lung. Microscopic findings showed a spindle cell tumor with prominent nuclear pleomorphism. Immunohistochemical studies revealed that the tumor cells were positive for vimentin only. Further analysis, combining the current case with 13 cases from the literature, showed no specific grading or types of sarcoma associated with sudden death. Six of the 14 cases were younger than 1 year old. Ten cases did not have a history of sarcoma prior to death, and 7 of these 10 cases had primary sarcoma sites in vital organs. In the 4 cases with sarcoma history, only 1 case showed a primary site developing in a vital organ. However, the differences in history between these groups were not significant (p = .145). Conclusion:No types or grading of sarcoma were found to be associated with sudden death. The cases without a prior medical history of sarcoma, compared to the cases with a sarcoma history, seemed to have primary sites in vital organs, but the results were not statistically significant. More studies are needed to clarify the relationship between the history and primary site of sarcoma and sudden death.

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“…By adhering to the vascular endothelium, the tumor cells are thought to activate the coagulation cascade directly through tissue factor (TF) as well as through the induction of inflammatory cytokines such as interleukin 6 (IL-6) and tumor necrosis factor (TNF). [13][14][15][16] Tumor cells, and tumor cell-derived microparticles, express TF on the cell membrane inducing thrombin generation, increasing the risk of thrombosis. [13][14][15] In addition to cleaving fibrinogen, increased thrombin generation induces platelet activation and aggregation resulting in the formation of platelet and fibrin-rich microthrombi.…”

mentioning

confidence: 99%

“…[13][14][15][16] Tumor cells, and tumor cell-derived microparticles, express TF on the cell membrane inducing thrombin generation, increasing the risk of thrombosis. [13][14][15] In addition to cleaving fibrinogen, increased thrombin generation induces platelet activation and aggregation resulting in the formation of platelet and fibrin-rich microthrombi. Activation of the protease-activated receptors by thrombin may result in endothelial subintimal and smooth muscle proliferation.…”

mentioning

confidence: 99%

“…Activation of the protease-activated receptors by thrombin may result in endothelial subintimal and smooth muscle proliferation. [13][14][15][16] There is laboratory evidence of DIC, with elevate D-dimers. In addition, plateletderived growth factor-A and vascular endothelial growth factor-C (VEGF-C) may be increased in PTTM and may contribute to the pathogenesis.…”

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confidence: 99%

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Thrombotic Microangiopathy in Cancer

Weitz

2019

Semin Thromb Hemost

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Thrombotic microangiopathy (TMA) is a rare but often devastating complication of cancer and cancer treatment. The syndrome is defined by thrombocytopenia (i.e., a platelet count of < 150,000/mcL or > 30% decrease from baseline), microangiopathic hemolytic anemia, and some evidence of organ damage. Among the nine recognized groups of disorders causing TMA, the focus of this article will be on cancer and cancer treatment-related causes of TMA. This review will discuss the pathophysiology of TMA in cancer, chemotherapy-associated TMA, transplant-associated TMA, and newer therapeutic modalities.

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Sudden Death by Occult Metastatic Carcinoma

Cited by 6 publications

References 10 publications

Gastrointestinal causes of sudden unexpected death: A review

Gastrointestinal causes of sudden unexpected death: A review

Sudden Death Due to Sarcoma: An Unusual Case and Literature Review

Thrombotic Microangiopathy in Cancer

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