Chemotherapy-Induced Spontaneous Pneumothorax in a Patient with Bulky Mediastinal Lymphoma: A Rare Oncologic Emergency

Abstract

Chemotherapy-induced spontaneous pneumothorax (SP) has been described sporadically in chemosensitive tumors, particularly sarcoma, with multiple lung metastases. We present a patient who developed SP following rapid regression of bulky mediastinal lymphoma. Immediately on chest tube insertion, the lung recovered and further chemotherapy could be delivered uneventfully. We suggest that (1) chemotherapy-induced SP should be included amongst oncologic emergencies and that (2) a high degree of awareness of this complication is required.

Outcome of Radical Surgery for Pulmonary Metastatic Osteosarcoma with Secondary Spontaneous Pneumothorax: Case Series Report

“…4,5) Only one patient exhibited internal necrosis, with SSP occurring 31 days after chemotherapy initiation. We presume that SSP occurred because of internal ischemic changes for the large 95-mm lesion rather than because of chemotherapy.…”

Spontaneous Pneumothorax During Chemotherapy: A Case Report

“…Apart from sarcomas, thiscomplicationhasalsobeenreportedinpatientswithlung metastasesfrommalignanciessuchasgermlinetumours,nonepithelialgynaecologicalmalignancies,insomepatientswith lymphomas and small-cell lung cancer. These non-sarcoma casesofSParesummarisedintable1 [3][4][5][6].Itisnoteworthy thatSPcomplicatingchemotherapyhasnotbeenreportedin someofthemorecommonmalignanciessuchas,e.g.,breast cancer or malignancies originating from the gastrointestinal tract.…”

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

“…These included 7 patients with osteogenic sarcoma, 7 with germinal tumors, 3 with uterine leiomyosarcoma, 2 with endometrial carcinoma, 2 with synovial cell sarcoma, 2 with lymphoma, and 1 each with Wilm's tumor, thymoma, small cell lung cancer, adenocarcinoma from an unknown primary, and breast cancer. [3][4][5][6][7][8] The actual mechanism of the complicating pneumothorax in primary and metastatic lung cancer is not completely understood, but the pathophysiology would depend on the particular tumor involved. For example, in primary lung cancer the SSP may be produced either by the pathological lung abnormalities that occur secondary to smoking, or by progression of the tumor, causing rupture of an ischemic primary lesion into the pleural space.…”

“…1 However, secondary spontaneous pneumothorax (SSP) is rarely associated with primary lung cancer, 2 although it has been documented as a complication of pulmonary metastases, either before or after chemotherapy and radiotherapy. 3 therapy. In April 1997, 1 month later, the patient became acutely dyspneic and re-presented to the hospital with signs of acute respiratory insufficiency: a chest Xray revealed a bilateral spontaneous pneumothorax, 90% in the left side and 60% in the right side.…”