Pulmonary tumour embolism from gastric adenocarcinoma causing respiratory and cardiac failure may not be identified on standard ante-mortem imaging

Authors

• Konstantīns Ščerbakovs Department of Lung Diseases and Thoracic Surgery, Pauls Stradins Clinical University Hospital, Riga, Latvia; Riga Stradins University, Riga, Latvia
• Valentīna Mihejeva Department of Lung Diseases and Thoracic Surgery, Pauls Stradins Clinical University Hospital, Riga, Latvia; Riga Stradins University, Riga, Latvia
• Sergejs Dubencovs Department of Pathology, Pauls Stradins Clinical University Hospital, Riga, Latvia
• Evelīna Stunda Department of Pathology, Pauls Stradins Clinical University Hospital, Riga, Latvia
• Dace Žentiņa Department of Lung Diseases and Thoracic Surgery, Pauls Stradins Clinical University Hospital, Riga, Latvia; Riga Stradins University, Riga, Latvia

scerbakovs.k@gmail.com

Keywords

Abstract

Pulmonary tumour embolism is severe complication of malignancy, often presenting with progressive dyspnoea and respiratory failure. Due to their non-specific symptoms and absence of clear imaging findings, diagnosis is frequently delayed or made post-mortem. This is a case of previously undiagnosed gastric adenocarcinoma presenting with rapidly worsening respiratory symptoms: hypoxaemia, pulmonary hypertension and heart failure. Standard imagining – computed tomography angiography and echocardiography – provide indirect evidence, definitive diagnosis of pulmonary tumour embolism confirmed post-mortem. This case highlights the diagnostic challenges associated with a pulmonary tumour embolism and underscores the importance of early suspicion of malignancy-related complications in cases of progressive respiratory and cardiac failure without radiographic evidence of pulmonary embolism.

References