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Spontaneous bilateral pneumothorax in metastatic renal cell carcinoma on sunitinib therapy

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Abstract

Bilateral spontaneous pneumothorax is a rare occurrence in patients with both primary and metastatic lung cancer. Pneumothorax occurring as a complication of vascular endothelial growth factor receptor (VEGFR) inhibitor therapy has not been previously described in the medical literature. Sunitinib malate is a VEGFR inhibitor approved for the treatment of advanced renal cell carcinoma. We present a patient with metastatic renal cell carcinoma manifested as bilateral pulmonary nodules who developed a bilateral spontaneous pneumothorax 3 weeks after initiation of sunitinib therapy. We believe that sunitinib therapy resulted in necrosis of multiple pleural-based pulmonary nodules with central cavernization and ultimately rupture with bronchopleural fistula formation. Based on this experience, we advise that practitioners exercise caution when prescribing anti-VEGFR therapy in patients with pleural-based pulmonary metastases and recognize that the efficacy and toxicity of these agents may be closely linked.

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Authors and Affiliations

  1. Department of Internal Medicine, Saint Louis University School of Medicine, Saint Louis, MO, USA

    Anilkumar Katta & Giao Vuong

  2. Division of Hematology and Medical Oncology, Department of Internal Medicine, Saint Louis University School of Medicine, West Pavilion, 3655 Vista Avenue, Saint Louis, MO, 63110, USA

    Mark J. Fesler, Alan Tan & John M. Richart

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  1. Anilkumar Katta
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  2. Mark J. Fesler
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  3. Alan Tan
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  4. Giao Vuong
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  5. John M. Richart
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Correspondence to Mark J. Fesler.

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Katta, A., Fesler, M.J., Tan, A. et al. Spontaneous bilateral pneumothorax in metastatic renal cell carcinoma on sunitinib therapy. Cancer Chemother Pharmacol 66, 409–412 (2010). https://doi.org/10.1007/s00280-010-1291-3

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  • DOI: https://doi.org/10.1007/s00280-010-1291-3

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