Pulmonary tumor embolism
PTE is typically discovered in autopsy, but rarely may become clinically apparent.
Most commonly caused by mucin-secreting adenocarcinomas of the breast, lung, stomach, and colon. May also be caused by malignancies of the renal cells, prostate, cervix, ovaries, bladder, skin, pancreas, parotid, and thyroid, or by mesothelioma, choriocarcinoma, hepatocellular carcinoma, atrial myxoma, or Wilms tumor.
Clinical presentation is variable. Most patients present with dyspnea. Pleuritic chest pain is common. Less frequently occurring symptoms include fatigue, weight loss, cough, and hemoptysis. Tachycardia is usually apparent upon physical examination. Some features of pulmonary hypertension and cor pulmonale include increase in the pulmonic component of the second heart sound, a right ventricular lift, cyanosis, and jugular venous distention. The majority of PTE cases are detected in patients with a known malignancy; however, in rare cases, PTE may be the presenting manifestation in an occult neoplasm.
Treatment is aimed at the primary tumor.
Although pulmonary tumor emboli are not metastatic, survival is usually poor after the onset of presenting symptoms. This may be due to the association with concomitant lymphangitic or metastatic carcinoma.
I74.9 – Embolism and thrombosis of unspecified artery
252986008 – Tumor embolus