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. 2023 Mar 15:10:101715.
doi: 10.1016/j.jaccas.2022.101715.

A Case of Fulminant Right Heart Failure Owing to Tumoral Pulmonary Hypertension

Kedong Wang  1 , Anuj Verma  2 , Kaitlin E Fish  2 , Jiun-Ruey Hu  1 , P Elliott Miller  1 , Jon S Morrow  2 , Inderjit Singh  3 , Lawrence H Young  1
Affiliations

A Case of Fulminant Right Heart Failure Owing to Tumoral Pulmonary Hypertension

Kedong Wang et al. JACC Case Rep. .

Abstract

Tumoral pulmonary hypertension is a rare cause of pulmonary hypertension. We report a patient who was thought to have idiopathic pulmonary arterial hypertension, but later developed fulminant right heart failure ultimately leading to death. Autopsy revealed substantial pulmonary tumor embolism burden originating from liver adenocarcinoma. (Level of Difficulty: Advanced.).

Keywords: acute heart failure; cancer; pulmonary hypertension.

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Conflict of interest statement

The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Gross and Microscopic Images of the Liver and Lungs (A) Cut surface of the liver showing 2 soft yellow-green predominantly circumscribed masses replacing much of the normal liver. Vascular invasion into a vessel is circled and also shown at 2× (inset). (B and C) Microscopic images of liver masses showing a neoplasm arranged in a pseudo-acinar pattern with abundant eosinophilic cytoplasm and prominent nucleoli. (D) Cut surface of the right lung is tan-red and crepitant without gross lesions. (E and F) Microscopic examination of both lungs revealed extensive hepatocellular carcinoma emboli in the pulmonary vasculature. Both medium sized vessels and alveolar capillaries were obstructed. A tumor embolus blocking the exit from a larger vessel is shown (F, large arrow). Objective magnification: B, ×100; C, ×400; E, ×40; F, ×100.
See this image and copyright information in PMC

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