<- Home <- Arhive <- Vol. 26, Issue 4, December 2018

Rom J Leg Med26(4)377-381(2018)
© Romanian Society of Legal Medicine

Sudden death due to pulmonary tumor microembolism in an unknown primary malignancy

S. Wang, L. Ren, W. Chen, Y. Shang, L. Yang, H. Xie

Abstract: We report the case of a 51-year-old male who initially presented with chronically developing dyspnea, interrupted syncope and thoracic pains. Chest X-Ray and computed tomography (CT) performed bronchial pneumonia and pulmonary infection. An antibiotic therapy given in the meantime led to recovery, but the general condition of the patient was deteriorating continuously. A day later, the patient died of refractory arrhythmia and respiratory failure. Autopsy revealed parenchymal haemorrhages and multiple infarctions of bilateral lungs. Histologically, pulmonary arteries, arterioles, and capillaries were occluded by extensive tumor emboli. Primary tumor sites were not found despite extensive search. In this paper, the difficulty to diagnose pulmonary tumor microembolism associated with an adenocarcinoma of unknown primary and the medico-legal implications are presented. Meanwhile, the discussion also gives a short survey concerned with published cases of pulmonary tumor microembolism.
Keywords: Pulmonary tumor microembolism, carcinoma of unknown primary metastasis, medical disputes.

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