Abstract
Pulmonary tumor thrombotic microangiopathy (PTTM) is a rapidly progressive pulmonary disease complicated by malignancy. It manifests clinically as respiratory distress with pulmonary hypertension, progressive right sided heart failure, and sudden death. We describe a case of PTTM associated with metastatic gastric carcinoma. This case demonstrates the diagnostic diffi culties in such a rare and rapidly fatal oncological complication. More awareness among clinicians may help make a right diagnosis in the short time available. We also review the literatures to demonstrate the clinical characteristics that might provide clues towards an antemortem diagnosis, and may provide the key in treating PTTM.