Treatment with systemic chemotherapy, tadalafil, and off-label imatinib led to improved symptoms and partial echocardiographic recovery in a 72-year-old man with PTTM.
Case Report (n=1)
Early, targeted intervention with chemotherapy, tadalafil, and imatinib may offer temporary stabilization in selected patients with pulmonary tumor thrombotic microangiopathy.
Abstract Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare and often fatal cause of rapidly progressive pulmonary hypertension, typically associated with gastrointestinal malignancies. We report the case of a 72-year-old man with a history of diabetes and hyperlipidemia who presented with subacute exertional dyspnea, fatigue, and significant weight loss. Imaging and right heart catheterization revealed severe precapillary pulmonary hypertension, and further workup confirmed metastatic adenocarcinoma, presumed gastrointestinal in origin. He was diagnosed with PTTM based on clinical, radiographic, and histopathologic findings. Treatment with systemic chemotherapy, tadalafil, and off-label imatinib led to improved symptoms, reduced oxygen requirements, and partial echocardiographic recovery. This case highlights the importance of recognizing PTTM as a potential cause of pulmonary hypertension in patients with occult malignancy, and suggests that early, targeted intervention may offer temporary stabilization in selected patients. This abstract is funded by: None
G Ciprian (Fri,) conducted a case report in Pulmonary tumor thrombotic microangiopathy (PTTM) (n=1). Systemic chemotherapy, tadalafil, and off-label imatinib was evaluated. Treatment with systemic chemotherapy, tadalafil, and off-label imatinib led to improved symptoms and partial echocardiographic recovery in a 72-year-old man with PTTM.