Fatal cor pulmonale caused by pulmonary tumor microembolism in a patient with occult gastric cancer.

ABSTRACT

BACKGROUND: A fatal pulmonary tumor microembolism is rarely caused by an occult gastric cancer. METHODS AND RESULTS: We report the case of a 40-year-old woman who died after 3 days of progressive dyspnea, cough, and pulmonary hypertension. Postmortem examination demonstrated the presence of an occult diffuse-type gastric carcinoma, which had caused emboli in about 80% of small pulmonary arteries and arterioles. Despite an interatrial defect in the fossa ovalis, no parenchymal metastases were documented. CONCLUSION: Pulmonary tumor microembolism may be suspected in patients complaining of unexplained progressive dyspnea and who develop acute or subacute cor pulmonale.