A Fatal Case of Pulmonary Tumor Thrombotic Microangiopathy Originating From Primary Bladder Adenocarcinoma
- 1Department of Urology Sakai City Medical Center Sakai Osaka Japan.
- 2Department of Pathology Sakai City Medical Center Sakai Osaka Japan.
Abstract
Introduction
Pulmonary tumor thrombotic microangiopathy is a rare, fatal complication of malignancy, with few reports involving bladder cancer.Case presentation
An 81-year-old man with chronic obstructive pulmonary disease presented with hematuria and progressive exertional dyspnea. Imaging showed an invasive bladder tumor with lymph node metastases. Echocardiography suggested pulmonary hypertension, although invasive confirmation was unavailable. Recurrent perioperative oxygen desaturation preceded fatal deterioration 2 days after transurethral resection. Autopsy revealed primary bladder adenocarcinoma, signet ring cell subtype, and microscopic pulmonary tumor emboli with fibrin thrombi, fibrous intimal thickening, and recanalization. These findings supported pulmonary tumor thrombotic microangiopathy. Distinct gastrointestinal tumors and matching bladder and metastatic morphology supported a bladder origin.Conclusion
Pulmonary tumor thrombotic microangiopathy should be considered in patients with bladder tumors and progressive dyspnea. Recurrent desaturation and right heart abnormalities warrant reassessment despite preserved oxygen saturation. Autopsy vascular findings were essential to distinguish this condition from simple pulmonary tumor embolism.
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BibTeX
@article{kodani2026fatal,
title = {{A Fatal Case of Pulmonary Tumor Thrombotic Microangiopathy Originating From Primary Bladder Adenocarcinoma}},
author = {Hiroki Kodani and Yosuke Sekii and Yohei Inoguchi and Eisuke Tomiyama and Hitoshi Takayama and Yumiko Yasuhara},
journal = {IJU case reports},
year = {2026},
month = oct,
doi = {10.1002/iju5.70290},
url = {https://europepmc.org/article/PMC/PMC13717067},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - A Fatal Case of Pulmonary Tumor Thrombotic Microangiopathy Originating From Primary Bladder Adenocarcinoma
AU - Hiroki Kodani
AU - Yosuke Sekii
AU - Yohei Inoguchi
AU - Eisuke Tomiyama
AU - Hitoshi Takayama
AU - Yumiko Yasuhara
PY - 2026
DA - 2026/10/28
JO - IJU case reports
DO - 10.1002/iju5.70290
UR - https://europepmc.org/article/PMC/PMC13717067
AB - Introduction Pulmonary tumor thrombotic microangiopathy is a rare, fatal complication of malignancy, with few reports involving bladder cancer.Case presentation An 81-year-old man with chronic obstructive pulmonary disease presented with hematuria and progressive exertional dyspnea. Imaging showed an invasive bladder tumor with lymph node metastases. Echocardiography suggested pulmonary hypertension, although invasive confirmation was unavailable. Recurrent perioperative oxygen desaturation preceded fatal deterioration 2 days after transurethral resection. Autopsy revealed primary bladder adenocarcinoma, signet ring cell subtype, and microscopic pulmonary tumor emboli with fibrin thrombi, fibrous intimal thickening, and recanalization. These findings supported pulmonary tumor thrombotic microangiopathy. Distinct gastrointestinal tumors and matching bladder and metastatic morphology supported a bladder origin.Conclusion Pulmonary tumor thrombotic microangiopathy should be considered in patients with bladder tumors and progressive dyspnea. Recurrent desaturation and right heart abnormalities warrant reassessment despite preserved oxygen saturation. Autopsy vascular findings were essential to distinguish this condition from simple pulmonary tumor embolism.
SN - 2577-171X
ER -