{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T03:38:35Z","timestamp":1761709115444},"reference-count":10,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,8,12]],"date-time":"2015-08-12T00:00:00Z","timestamp":1439337600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Forensic Sciences"],"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>A 33\u2010year\u2010old female collapsed and died suddenly after presenting with acute dyspnea and increasing cough over the preceding several months. Autopsy revealed poorly differentiated linitis plastica adenocarcinoma of the stomach. Microscopic examination of the lungs showed features consistent with pulmonary tumor thrombotic microangiopathy (<jats:styled-content style=\"fixed-case\">PTTM<\/jats:styled-content>). <jats:styled-content style=\"fixed-case\">PTTM<\/jats:styled-content> is a well\u2010described complication in patients with adenocarcinoma. The typical presentation involves acute pulmonary hypertension, right\u2010sided heart failure, and sudden death, often before the adenocarcinoma is discovered. The pathophysiology of <jats:styled-content style=\"fixed-case\">PTTM<\/jats:styled-content> remains elusive; it has been suggested that carcinoma cells may produce substances that influence pulmonary vasculature. Our patient had classic clinical and histologic features of <jats:styled-content style=\"fixed-case\">PTTM<\/jats:styled-content> in addition to prominent extravascular compression by intralymphatic tumor cells. These features undoubtedly caused her precipitous decline and lethal pulmonary hypertension, induced by underlying adenocarcinoma. This case demonstrates that sudden death can occur from pulmonary hypertension induced by metastatic carcinoma with remarkably little prior symptomatology.<\/jats:p>","DOI":"10.1111\/1556-4029.12837","type":"journal-article","created":{"date-parts":[[2015,8,12]],"date-time":"2015-08-12T11:26:28Z","timestamp":1439378788000},"page":"1637-1639","source":"Crossref","is-referenced-by-count":4,"title":["Sudden Death by Occult Metastatic Carcinoma"],"prefix":"10.1111","volume":"60","author":[{"given":"Stephanie A.","family":"Dean","sequence":"first","affiliation":[{"name":"Maryland Office of the Chief Medical Examiner 900 West Baltimore Street Baltimore MD 21223"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Mathis","sequence":"additional","affiliation":[{"name":"Miami\u2010Dade County Medical Examiner Department 1851 NW 10th Ave Miami FL 33136"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leslie A.","family":"Litzky","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine University of Pennsylvania Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian C.","family":"Hood","sequence":"additional","affiliation":[{"name":"Burlington County Medical Examiner's Office 4 Academy Dr Westampton NJ 08060"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,8,12]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcfm.2005.02.006"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiographics.20.2.g00mc17491"},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197510)36:4<1473::AID-CNCR2820360440>3.0.CO;2-D"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19900801)66:3<587::AID-CNCR2820660330>3.0.CO;2-J"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2006.11.162"},{"key":"e_1_2_4_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(03)00305-X"},{"key":"e_1_2_4_8_1","doi-asserted-by":"publisher","DOI":"10.2459\/JCM.0b013e328354e473"},{"key":"e_1_2_4_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1092-9134(00)90038-8"},{"key":"e_1_2_4_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-013-1403-7"},{"key":"e_1_2_4_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-1-4160-5770-3.00011-0"}],"container-title":["Journal of Forensic Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1556-4029.12837","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1556-4029.12837","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,17]],"date-time":"2023-09-17T07:55:08Z","timestamp":1694937308000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1556-4029.12837"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,8,12]]},"references-count":10,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2015,11]]}},"alternative-id":["10.1111\/1556-4029.12837"],"URL":"https:\/\/doi.org\/10.1111\/1556-4029.12837","archive":["Portico"],"relation":{},"ISSN":["0022-1198","1556-4029"],"issn-type":[{"value":"0022-1198","type":"print"},{"value":"1556-4029","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,8,12]]}}}