Some pulmonary emboli are caused by detached fragments of tumors that are released into the vena cava and carried to the lungs.


Tumors often associated with tumor emboli to the lung:

(1) renal cell carcinoma

(2) hepatocellular carcinoma


Tumors which occasionally may cause tumor emboli to the lung:

(1) adrenal cell carcinoma

(2) cholangiocarcinoma

(3) pancreatic carcinoma

(4) carcinoma of the renal pelvis

(5) angiomyolipoma

(6) sarcoma

(7) testicular tumors


Presentations may include:

(1) acute cor pulmonale (with massive tumor embolus)

(2) single pulmonary embolus

(3) recurrent episodes with small emboli


Diagnosis may be made:

(1) at autopsy

(2) based on the presence of a known tumor

(3) based on histologic examination of thrombus removed at surgery

(4) by imaging studies demonstrating tumor or intravascular tumor extensions

(5) other findings indicative of metastatic cancer in skin, bone, lung, etc.


Differential diagnosis:

(1) pulmonary embolism secondary to tumor-related hypercoagulability


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