ACUTE COR-PULMONALE DUE TO TUMOR-CELL MICROEMBOLI

Severe pulmonary hypertension due to tumor cell microemboli or lymphan gitic carcinomatosis is a rare complication of malignant disease, In m ost of the reported cases, a clinical picture of subacute cor pulmonal e developed, A 57-year-old man with deep vein thrombosis in his left c alf developed acute progressive dyspnea with hypoxemia, cyanosis and t he clinical picture of acute cor pulmonale, while he was on full hepar inization, Respiratory failure with the need for mechanical ventilator y support developed within 2 days, Chest radiography revealed the deve lopment of acute cardiac enlargement, dilated pulmonary artery and dif fuse opacities in the fields of both lungs, Open lung biopsy disclosed massive tumor cell microemboli and lymphangitic carcinomatosis, No pa renchymal metastases were found. This case is extremely rare because o f the rapid development of the patient's respiratory signs and symptom s of acute cor pulmonale due to pulmonary tumor cell microemboli and l ymphangitic carcinomatosis. It is also most atypical because of the ra re pulmonary radiographic presentation.