{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T15:58:16Z","timestamp":1762444696183,"version":"3.44.0"},"reference-count":9,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,6,6]]},"abstract":"<jats:p>We report the case of a previously healthy man who presented with subacute dyspnoea after a long drive. He developed hypoxic respiratory failure, thought secondary to a massive pulmonary embolism and was treated with tissue plasminogen activator but died in the hospital despite aggressive medical measures. Autopsy revealed pulmonary tumour thrombotic microangiopathy (PTTM) from papillary renal cell carcinoma. PTTM is a rare clinicopathological syndrome that clinically results in symptoms of dyspnoea and right heart failure. Pathologically, a localised paraneoplastic process evolves from tumour microemboli in the pulmonary arterioles, resulting in fibrocellular proliferation and narrowing of the vessels, causing subacute right heart failure. To our knowledge, this is the first case of PTTM due to papillary renal cell carcinoma.<\/jats:p>","DOI":"10.1136\/bcr-2017-219730","type":"journal-article","created":{"date-parts":[[2017,6,28]],"date-time":"2017-06-28T07:20:16Z","timestamp":1498634416000},"page":"bcr-2017-219730","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Acute cor pulmonale due to pulmonary tumour thrombotic microangiopathy from renal cell carcinoma"],"prefix":"10.1136","volume":"2017","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3470-4300","authenticated-orcid":false,"given":"Maria","family":"Story","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sook Kyung","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Robinson","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Spyridon","family":"Fortis","sequence":"additional","affiliation":[{"name":"Pulmonary, Critical Care and Occupational Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,6,28]]},"reference":[{"key":"2025082804292196000_2017.jun28_1.bcr-2017-219730.1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19900801)66:3<587::AID-CNCR2820660330>3.0.CO;2-J"},{"key":"2025082804292196000_2017.jun28_1.bcr-2017-219730.2","first-page":"7","article-title":"A case of pulmonary tumour thrombotic microangiopathy","volume":"16","author":"McAnearney","year":"2015","journal-title":"Respir Med Case Rep"},{"key":"2025082804292196000_2017.jun28_1.bcr-2017-219730.3","doi-asserted-by":"crossref","first-page":"1505","DOI":"10.1016\/j.rmed.2015.10.002","article-title":"Pulmonary manifestations of renal cell carcinoma","volume":"109","author":"Agrawal","year":"2015","journal-title":"Respir Med"},{"key":"2025082804292196000_2017.jun28_1.bcr-2017-219730.4","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1097\/MD.0000000000000219","article-title":"Pulmonary tumor thrombotic microangiopathy: report of 3 cases and review of the literature","volume":"93","author":"Gainza","year":"2014","journal-title":"Medicine"},{"key":"2025082804292196000_2017.jun28_1.bcr-2017-219730.5","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1097\/MCP.0000000000000297","article-title":"Pulmonary tumour thrombotic microangiopathy","volume":"22","author":"Price","year":"2016","journal-title":"Curr Opin Pulm Med"},{"key":"2025082804292196000_2017.jun28_1.bcr-2017-219730.6","doi-asserted-by":"crossref","first-page":"190","DOI":"10.3904\/kjim.2015.107","article-title":"Acute cor pulmonale due to pulmonary tumor thrombotic microangiopathy in two patients with breast cancer","volume":"32","author":"Moon","year":"2017","journal-title":"Korean J Intern Med"},{"key":"2025082804292196000_2017.jun28_1.bcr-2017-219730.7","doi-asserted-by":"crossref","DOI":"10.1186\/s12885-016-2721-3","article-title":"Antemortem diagnosis of pulmonary tumor thrombotic microangiopathy in a patient with recurrent breast Cancer: a case report","volume":"16","author":"Takahashi","year":"2016","journal-title":"BMC Cancer"},{"key":"2025082804292196000_2017.jun28_1.bcr-2017-219730.8","doi-asserted-by":"crossref","unstructured":"Banno A , Chiba K , Kasai H , et al . Ante-mortem diagnosis of pulmonary tumour thrombotic microangiopathy in a patient with unrecognised extramammary Paget's disease. BMJ Case Rep 2016;2016.doi:10.1136\/bcr-2016-216666","DOI":"10.1136\/bcr-2016-216666"},{"key":"2025082804292196000_2017.jun28_1.bcr-2017-219730.9","first-page":"1","article-title":"Pulmonary tumor thrombotic microangiopathy caused by prostate carcinoma","volume":"5","author":"Katayama","year":"2016","journal-title":"Acta Radiol Open"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2017-219730","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:29:31Z","timestamp":1756380571000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2017-219730"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,6,28]]},"references-count":9,"alternative-id":["10.1136\/bcr-2017-219730"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2017-219730","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2017,6,28]]}}}