Spontaneous pneumothorax as the first manifestation of Ewing's sarcoma

Vega, F. Arias de la; Illarramendi, J.J.; Martínez, E.; Vila, Eva; Martínez-Peñuela, J.M.; Domínguez, M. Ángeles

doi:10.1002/ppul.1950190307

Cited by 8 publications

(4 citation statements)

References 9 publications

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“…Pneumothorax as a complication before treatment or after initiating cytotoxic chemotherapy, radiation, or targeted biologic agents, including antiangiogenic agents (e.g., pazopanib, cediranib, sunitinib, or bevacizumab) in patients with pulmonary malignancy has been reported for several tumor types. [ 11 – 26 ] In most series reported in the literature, the incidence of pneumothorax is less than 5%. [ 17 , 21 , 23 , 27 ] However, we found a higher incidence (33%) of pneumothorax in our patients: 11 of 33 patients with pulmonary nodules developed pneumothorax in various tumor types while receiving sorafenib, bevacizumab, and low-dose cyclophosphamide, while no pneumothoraces were noted in the 11 patients without pulmonary nodules.…”

Section: Discussionmentioning

confidence: 99%

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

Interiano¹,

McCarville²,

Wu³

et al. 2015

Journal of Pediatric Surgery

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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.

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Section: Discussionmentioning

confidence: 99%

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

Interiano¹,

McCarville²,

Wu³

et al. 2015

Journal of Pediatric Surgery

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“…In the past, spontaneous pneumothorax has been reported in up to 11% of patients with sarcoma, either before or after treatment such as radiation therapy and cytotoxic chemotherapy. 20,[30][31][32][33][34] After the introduction of antiangiogenic therapy, including TKIs, an increased number to 25% of cases with spontaneous pneumothorax have been noted during cancer therapy. 10,[14][15][16]35,36 Prior studies suggested an association between pneumothorax and cavitation of pulmonary metastasis.…”

Section: Discussionmentioning

confidence: 99%

Tyrosine kinase inhibitor therapy in pediatric sarcoma: Prognostic implications of pulmonary metastatic cavitation

Morakote

Adams

Ramasamy

et al. 2023

Pediatric Blood & Cancer

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PurposesThis study aims to ascertain the prevalence of cavitations in pulmonary metastases among pediatric and young adult patients with sarcoma undergoing tyrosine kinase inhibitor (TKI) therapy, and assess whether cavitation can predict clinical response and survival outcomes.MethodsIn a single‐center retrospective analysis, we examined chest computed tomography (CT) scans of 17 patients (median age 16 years; age range: 4–25 years) with histopathologically confirmed bone (n = 10) or soft tissue (n = 7) sarcoma who underwent TKI treatment for lung metastases. The interval between TKI initiation and the onset of lung nodule cavitation and tumor regrowth were assessed. The combination of all imaging studies and clinical data served as the reference standard for clinical responses. Progression‐free survival (PFS) was compared between patients with cavitating and solid nodules using Kaplan–Meier survival analysis and log‐rank test.ResultsFive out of 17 patients (29%) exhibited cavitation of pulmonary nodules during TKI therapy. The median time from TKI initiation to the first observed cavitation was 79 days (range: 46–261 days). At the time of cavitation, all patients demonstrated stable disease. When the cavities began to fill with solid tumor, 60% (3/5) of patients exhibited progression in other pulmonary nodules. The median PFS for patients with cavitated pulmonary nodules after TKI treatment (6.7 months) was significantly longer compared to patients without cavitated nodules (3.8 months; log‐rank p‐value = .03).ConclusionsCavitation of metastatic pulmonary nodules in sarcoma patients undergoing TKI treatment is indicative of non‐progressive disease, and significantly correlates with PFS.

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“…Spontaneous pneumothorax has been described most frequently with lung cancers, and etiologies were thought to be multifactorial including the tumor itself, changes of the tumor with therapies such a radiation, and pre-existing parenchymal abnormalities such as obstructive lung disease [6]. A few reports have described spontaneous pneumothorax as a sequelae of treatment in those with pulmonary metastases and chemosensitive malignancies, and rarely as a presentation of the cancer itself [[7], [8], [9]].…”

Section: Discussionmentioning

confidence: 99%

Bilateral spontaneous pneumothoraces in anaplastic thyroid cancer

Kazzaz

Cabanillas

Bashoura

et al. 2019

Respiratory Medicine Case Reports

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Spontaneous pneumothorax is rarely associated with cancer. We describe a 73 year old man who presented with recurrent tumor in the right neck, mediastinal lymphadenopathy and bilateral pulmonary nodules after thyroidectomy. He was treated with lenvatinib and presented with bilateral pneumothoraces. Anaplastic thyroid cancer is an aggressive subtype of thyroid cancer that has limited response to cytotoxic chemotherapy and poor prognosis. Recent reports show that targeted therapy with a multiple receptor tyrosine kinase inhibitor, lenvatinib, may have improvement in progression-free survival, but rarely pneumothorax has been reported in those with lung metastases. Various mechanisms have been postulated, but necrosis of pulmonary lesions and/or subpleural micrometastases leading to bilateral pleural defects likely resulted in the development of pneumothoraces for our patient.

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Spontaneous pneumothorax as the first manifestation of Ewing's sarcoma

Cited by 8 publications

References 9 publications

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

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

Tyrosine kinase inhibitor therapy in pediatric sarcoma: Prognostic implications of pulmonary metastatic cavitation

Bilateral spontaneous pneumothoraces in anaplastic thyroid cancer

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