Spontaneous pneumothorax after chemotherapy for sarcoma with lung metastases: Case report and consideration of pathogenesis

Alfonso Fiorelli, Giovanni Vicidomini, Filomena Napolitano, Mario Santini


Spontaneous pneumothorax is a rare complication of chemotherapy for lung neoplasm. Herein, we report a case of right spontaneous pneumothorax occurring in a patient in whom lung metastases from synovial cell sarcoma were treated with combination chemotherapy. Chest tube alone was unable to attempt the resolution of air leaks. Thus, it was connected to gentle suction set at minus 15 cm of water which achieved complete re-expansion of the lung with reduction of air leaks. In closure, chemical pleurodesis was attempted using 5 gram of talc diluted in 50 ml normal saline solution instilled into the right pleural cavity via chest tube. The connecting tube was suspended at 30 cm above the level of the patient\'s chest for one hour and the patient\'s position was changed at 15 minutes intervals to ensure uniform distribution. At three months of follow-up, the patient had no-recurrence of pneumothorax.