title: Acute cor pulmonale due to microscopic tumour embolism as the first manifestation of hepatocellular carcinoma.
abstract: Microscopic pulmonary tumour embolism is a rare cause of pulmonary hypertension. In most of the reported cases, symptoms develop over several days or weeks in patients previously diagnosed with malignant diseases. In our case, a 41-year-old man with an unremarkable medical history presented with respiratory failure that led to death less than 48 h from the onset of symptoms. Autopsy revealed massive microscopic pulmonary tumour embolism and a multifocal hepatocellular carcinoma. This case report is exceptional because it describes a very rapid clinical progression, and because acute cor pulmonale was the first manifestation of a previously undiagnosed neoplastic disease.
authors.affiliation: Departments of Emergency Medicine and Pathology, Hospital de Basurto, Bilbao, Spain. alguma@teleline.es
authors.forename: Alfonso
authors.initials: A
authors.lastname: Gutiérrez-Macías
authors.forename: Kepa Elorriaga
authors.initials: KE
authors.lastname: Barandiarán
authors.forename: Francisco J Bilbao
authors.initials: FJ
authors.lastname: Ercoreca
authors.forename: Mikel Martínez-Ortíz
authors.initials: MM
authors.lastname: De Zárate
mesh_terms: D000208:Acute Disease; D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000175:diagnosis; D008168:Lung / Q000473:pathology; D008297:Male; D009360:Neoplastic Cells, Circulating; D011655:Pulmonary Embolism / Q000209:etiology* / Q000473:pathology; D011660:Pulmonary Heart Disease / Q000209:etiology* / Q000473:pathology