Platelet-derived growth factor receptor-tyrosine kinase inhibitor, imatinib, is effective for treating pulmonary hypertension induced by pulmonary tumor thrombotic microangiopathy.
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| Abstract |
Pulmonary hypertension (PH) induced by pulmonary tumor thrombotic microangiopathy (PTTM) can be fatal because its rapid progression confounds diagnosis, and it is difficult to control with therapy. Here we describe a woman with symptomatic PTTM-PH accompanying gastric cancer that was suspected from perfusion scintigraphy. PTTM-PH was diagnosed by gastroesophageal endoscopy and lung biopsy after partial control of PH using the platelet-derived growth factor (PDGF) receptor (PDGFR) tyrosine kinase inhibitor, imatinib. Treatment with sildenafil and ambrisentan further decreased PH, and she underwent total gastrectomy followed by adjuvant TS-1 chemotherapy. PH did not recur before her death from metastasis. Postmortem histopathology showed recanalized pulmonary arteries where the embolized cancer masses disappeared. PDGF-A, -B, and PDGFR-α, β expression was detected in cancer cells and proliferating pulmonary vascular endothelial cells. Thus, PTTM-PH was successfully controlled using a combination of imatinib, drugs to treat pulmonary arterial hypertension, and cancer management.
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| Authors | Shun Minatsuki, Ichiro Miura, Atsushi Yao, Hiroyuki Abe, Hironori Muraoka, Mariko Tanaka, Teruhiko Imamura, Toshiro Inaba, Hisataka Maki, Masaru Hatano, Koichiro Kinugawa, Takashi Yao, Masashi Fukayama, Ryozo Nagai, Issei Komuro |
| Journal | International heart journal (Int Heart J) Vol. 56 Issue 2 Pg. 245-8 ( 2015) ISSN: 1349-3299 [Electronic] Japan |
| PMID | 25740390 (Publication Type: Case Reports, Journal Article) |
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