Pulmonary Tumor Thrombotic Microangiopathy Caused by Metastatic Ovarian High-Grade Serous Carcinoma: A Case Report and Literature Review

Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare entity with poor prognosis, and often diagnosed postmortem [2]. PTTM is considered as the result of widespread pulmonary tumor microemboli (PTME) induced coagulation cascade activation, fibrin clot formation and fibrocellular intimal proliferation causing vascular luminal stenosis mainly in the pulmonary arterioles and small arteries [3,4]. PTTM leads to increase in pulmonary vascular resistance causing pulmonary hypertension [3,4]. Clinically, PTTM is presented as unexplained rapidly progressive dyspnea in a patient with known or unknown history of cancer [5]. PTTM can be caused by many cancers, with the most frequent ones being gastric, breast, and lung cancers [4,6]. Ovarian cancer is a rare primary malignancy for PTTM, accounting for approximately 2.7% of total reported cases of PTTM [4,6]. Here we report a rare case of postmortem-diagnosed PTTM caused by metastatic high-grade serous carcinoma of ovary, with literature review of PTTM secondary to ovarian cancer.

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