The risk of spontaneous pneumothorax in patients with osteogenic sarcoma and testicular cancer

Abstract

Seven cases of unilateral, spontaneous pneumothorax were found in a retrospective study of 63 patients with osteogenic sarcoma who were admitted to The Norwegian Radium Hospital (NRH) in the period 1970--1977. The relative risk of pneumothorax developing doubled, from 7--14%, after the introduction of chemotherapy for this disease at NRH. This difference was not statistically significant. Pneumothorax developed in two of 18 patients (11%) with lung metastases who never received chemotherapy. Pneumothorax occurred in four of 19 patients (21%) treated with chemotherapy for manifest lung metastases, and in one of eight patients (13%) who received adjuvant chemotherapy, but in whom lung metastases developed later. Pneumothorax did not develop in 79 patients treated with chemotherapy for disseminated testicular cancer, despite the fact that 82% of these patients had manifest lung metastases.

Bilateral spontaneous pneumothorax in an osteosarcoma patient with pulmonary metastases: A case report

“…It has been hypothesized that the pneumothorax was the result of ruptures of the necrotic subpleural micro metastasis in patients treated with chemotherapy (2). However, Smevik and Klepp reported that the bullous change caused the metastatic pulmonary disease, and that the peripheral tumor produced partial bronchial obstruction and caused a ball-valve phenomenon (8). This case provided us with radiographic evidence of this phenomenon.…”

“…The association of spontaneous pneumothorax with osteosarcoma is well known (1,6,7). Patients with osteosarcoma that have pulmonary metastases have a higher risk of spontaneous pneumothorax than patients with pulmonary metastatic carcinoma, but the reason for this remains unclear (8). It is also unclear whether there is any correlation between pneumothorax and lung metastasis (9).…”

“…It is also unclear whether there is any correlation between pneumothorax and lung metastasis (9). Regardless of whether patients with osteosarcoma have pulmonary metastases, those who receive chemotherapy have a higher risk of spontaneous pneumothorax than those who do not (8). It has been hypothesized that the pneumothorax was the result of ruptures of the necrotic subpleural micro metastasis in patients treated with chemotherapy (2).…”

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 without any detectable pulmonary metastases in a patient with osteosarcoma

“…Patients with metastatic osteosarcoma in the lung have a higher risk of spontaneous pneumothorax than patients with metastatic carcinoma, but the reason for this remains unclear [4]. Whether or not patients with osteosarcoma have pulmonary metastases, those who receive chemotherapy have a higher risk of spontaneous pneumothorax than those who do not [4]. It has been hypothesized that the pneumothorax was the result of ruptures of the necrotic subpleural micrometastasis in patients treated with chemotherapy [1].…”