Bilateral recurrent pneumothorax complicating chemotherapy for pulmonary metastatic breast ductal carcinoma: report of a case

Recurrent spontaneous pneumothoraxes as a complication of osteosarcoma metastases: a case report

Osteosarcoma is the most common primary malignant bone tumor in children and adolescents. Osteosarcomas are highly aggressive tumors that historically have had a dismal prognosis. However, the survival rate has improved significantly with the addition of adjuvant and neoadjuvant chemotherapy. Here, we present a case report of a 13-year-old male with a history of a left humeral osteosarcoma whose course was complicated by recurrent sarcoma-related pneumothoraces. Despite recurrent pneumothoraces being a relatively uncommon complication of osteosarcoma, they present a great challenge to providing treatment that optimizes outcomes and quality of life for patients.

Spontaneous pneumothorax associated with cavitating pulmonary metastasis from breast cancer: a case report and literature review

We report a 69-year-old woman with spontaneous pneumothorax associated with cavitating pulmonary metastasis from breast cancer. She was treated for right breast cancer (invasive ductal carcinoma, ypT4bN1M0, stage IIIB) 2 years earlier, and was admitted for right pneumothorax and chest computed tomography, which showed multiple small cavitating lesions in bilateral lungs. The pneumothorax was treated conservatively with chest drainage, but subsequently recurred ipsilaterally. During video-assisted thoracic surgery, we detected small white nodules with visceral pleural rupture; therefore, we performed partial lung resection. The pathological findings revealed metastatic breast cancer with pleural invasion. Forty days later, ipsilateral pneumothorax recurred, and chemical pleurodesis was performed, which resolved the pneumothorax and prevented subsequent recurrence. Early diagnosis and definitive treatment, including pleurodesis, should be considered to prevent recurrence of spontaneous pneumothorax and improve patients' quality of life, even in patients with advanced malignancy.

Pneumothorax as a complication of combination antiangiogenic therapy in children and young adults with refractory/recurrent solid tumors

PURPOSE

Antiangiogenic agents show significant antitumor activity against various tumor types. In a study evaluating the combination of sorafenib, bevacizumab, and low-dose cyclophosphamide in children with solid tumors, an unexpectedly high incidence of pneumothorax was observed. We evaluated patient characteristics and risk factors for the development of pneumothorax in patients receiving this therapy.

PATIENTS AND METHODS

Demographics, clinical course, and radiographic data of 44 patients treated with sorafenib, bevacizumab and cyclophosphamide were reviewed. Risk factors associated with the development of pneumothorax were analyzed.

RESULTS

Pneumothorax likely related to study therapy developed in 11 of 44 (25%) patients of whom 33 had pulmonary abnormalities. Median age of patients was 14.7 years (range, 1.08-24.5). Histologies associated with pneumothorax included rhabdoid tumor, synovial sarcoma, osteosarcoma, Ewing sarcoma, Wilms tumor, and renal cell carcinoma. Cavitation of pulmonary nodules in response to therapy was associated with pneumothorax development (P<0.001). Median time from start of therapy to development of pneumothorax was 5.7 weeks (range, 2.4-31).

CONCLUSION

The development of cavitary pulmonary nodules in response to therapy is a risk factor for pneumothorax. As pneumothorax is a potentially life-threatening complication of antiangiogenic therapy in children with solid tumors, its risk needs to be evaluated when considering this therapy.

Spontaneous pneumothorax after intensive chemotherapy in endometrial cancer: a rare complication

OBJECTIVE

Endometrial cancer with hematogenous metastases can be treated with chemotherapy. We present a case of spontaneous pneumothorax that occurred when a solitary pulmonary endometrial metastatic lesion was treated with paclitaxel plus carboplatin.

CASE REPORT

A 38-year-old female had stage II endometrial endometrioid adenocarcinoma. Solitary bilateral pulmonary metastases developed after primary treatment. Complete remission accompanied by a right spontaneous pneumothorax occurred during chemotherapy with paclitaxel plus carboplatin.

CONCLUSION

Rapid shrinkage of a pulmonary space-occupying tumor sometimes causes rare but life-threatening spontaneous pneumothoraces. We report the first case of a spontaneous pneumothorax after using paclitaxel plus carboplatin in the treatment of endometrial cancer.

Docetaxel (Taxotere®)-induced cavitary change of pulmonary metastatic lesions complicated by bilateral spontaneous pneumothoraces in a patient with primary adenocarcinoma of the lung

Pneumothorax is a complication that rarely occurs after chemotherapy for lung cancer. We report the chest computed tomography findings of a case of spontaneous pneumothorax complicating docetaxel (Taxotere®) treatment for pulmonary metastasis in a 70-year-old woman with pulmonary adenocarcinoma. The patient developed bilateral pneumothoraces, which was induced by changes in the cavitary pulmonary metastatic lesions, after systemic chemotherapy with docetaxel. The chest computed tomography findings and possible mechanisms of this unusual complication are discussed in this report.

Acute nonbacterial pleuritis caused by spontaneous rupture of metastatic pulmonary adenocarcinoma

Nonbacterial pleuritis caused by rupture of a metastatic adenocarcinoma is extremely rare and has not yet been reported. A 59-year-old man with a history of rectal cancer surgery 6 years earlier presented with a solitary lung mass in the periphery of the right lower lobe on computed tomography. Transbronchial biopsy disclosed a suspected metastatic adenocarcinoma, and he was admitted for pulmonary metastasectomy. He had been asymptomatic, but 4 weeks after the diagnostic bronchoscopy, the patient suddenly complained of a right back pain and dyspnea at rest; shortly after that, he developed a fever of 39 degrees C. A chest X-ray showed right pleural effusion, collapse of the right lower lobe, and elevation of the right diaphragmatic dome, but without pneumothorax. Emergent video-assisted thoracoscopy revealed a perforated tumor in the collapsed lower lobe, and a right lower lobectomy was carried out. The postoperative course was uneventful, and he was well without recurrent disease 2 years after pulmonary resection.