Sudden death from massive pulmonary tumor embolism due to hepatocellular carcinoma

Massive pulmonary embolism in cancer patients can be due to detached thromb i or tumor. Pulmonary tumor embolism is often undiagnosed antemortem. We re port a 52-year-old Chinese man admitted for management of hepatocellular ca rcinoma (HCC). Computerized tomography showed tumor involvement of hepatic Vein and inferior vena cava. He died suddenly on the day of admission. At a utopsy the main pulmonary arteries of both lungs were blocked by large tumo r emboli, the immediate cause of death. Although rapid death in patients wi th HCC is usually caused by intraperitoneal hemorrhage from spontaneous rup ture of tumor, massive pulmonary tumor embolism should also be considered i n these patients, especially when antemortem evidence of hepatic Vein and/o r inferior vena cava invasion is present. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.