Fatal cor pulmonale caused by pulmonary tumor microembolism in a patient with occult gastric cancer

BackgroundA fatal pulmonary tumor microembolism is rarely caused by an occult gastric cancer.Methods and resultsWe report the case of a 40-year-old woman who died after 3 days of progressive dyspnea, cough, and pulmonary hypertension. Postmortem examination demonstrated the presence of an occult diffuse-type gastric carcinoma, which had caused emboli in about 80% of small pulmonary arteries and arterioles. Despite an interatrial defect in the fossa ovalis, no parenchymal metastases were documented.ConclusionPulmonary tumor microembolism may be suspected in patients complaining of unexplained progressive dyspnea and who develop acute or subacute cor pulmonale.