Gayibov Emin, Karim Amin H
Third Faculty of Medicine, Charles University, Prague, CZE.
Department of Cardiovascular Disease, Baylor College of Medicine, Houston, USA.
Cureus. 2025 Jan 3;17(1):e76842. doi: 10.7759/cureus.76842. eCollection 2025 Jan.
Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare paraneoplastic syndrome associated with various adenocarcinomas, most commonly gastric adenocarcinoma. This condition can progressively worsen pulmonary arterial hypertension, leading to acute or subacute pulmonary heart failure and respiratory insufficiency. This paper examines the pathogenesis, clinical presentation, diagnosis, treatment, and prognosis of PTTM. Given PTTM's poor prognosis, we emphasize treatment strategies. PTTM in adenocarcinoma patients can mimic other pulmonary diseases, causing diagnostic delays. Current PTTM treatment strategies primarily focus on managing the underlying malignancy and addressing thrombotic complications. Anti-angiogenic therapy with bevacizumab and the platelet-derived growth factor receptor antagonist imatinib have shown promise in multiple cases. Further research is needed to develop more effective and targeted therapies for this challenging condition. The precise mechanisms underlying this association remain to be fully elucidated.
肺肿瘤血栓性微血管病（PTTM）是一种罕见的副肿瘤综合征，与多种腺癌相关，最常见的是胃腺癌。这种情况可使肺动脉高压逐渐加重，导致急性或亚急性肺心病和呼吸功能不全。本文探讨了PTTM的发病机制、临床表现、诊断、治疗及预后。鉴于PTTM预后较差，我们着重强调治疗策略。腺癌患者的PTTM可模仿其他肺部疾病，导致诊断延误。目前PTTM的治疗策略主要集中在治疗潜在的恶性肿瘤和处理血栓形成并发症。贝伐单抗抗血管生成治疗和血小板衍生生长因子受体拮抗剂伊马替尼在多个病例中已显示出前景。对于这种具有挑战性的疾病，需要进一步研究以开发更有效、更有针对性的治疗方法。这种关联背后的确切机制仍有待充分阐明。
