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Current Respiratory Medicine Reviews

Author(s): Faradila Nur Aini* and Isnin Anang Marhana*

DOI: 10.2174/1573398X18666220128110553

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Simultaneous Bilateral Secondary Pneumothorax Complicating Osteosarcoma: A Case Report

Page: [72 - 75] Pages: 4

  • * (Excluding Mailing and Handling)

Abstract

Background: The incidence of Simultaneous Bilateral Secondary Pneumothorax (SBSP) occurring as a complication of neoplasm is rare, only <1%. The lungs can be the site for the spread of metastatic osteosarcoma.

Methods: We investigated a 16-year-old female who was diagnosed with right distal femur osteosarcoma, pulmonary metastasis, and a rare SBSP complication. Pneumothorax was observed in both sites of pulmonary metastases and bronchopleural fistula on contrasting chest computed tomography.

Case Presentation: This pneumothorax is the second one; the previous one was only on one side before chemotherapy. The patient died 12 months after osteosarcoma was diagnosed and four months after SBSP occurred. The progression of osteosarcoma lesions was the cause for the death of the patient. SBSP is the leading cause of severe complications in osteosarcoma.

Conclusion: The clinician must perform diagnostic strategies for early detection of osteosarcoma and its proper management, which can reduce a patient’s suffering and impairment of the patient’s quality of life, thus decreasing morbidity and the risk of mortality.

Keywords: Cancer, metastases, osteosarcoma, pneumothorax, pulmonary, Hodgkin's lymphoma.

Graphical Abstract

[1]
Kumar LS, Sarangi PK, Mohanty J, Parida S. Spontaneous pneumothorax as the initial presentation in an osteosarcoma patient: a case report. AIMDR 2016; 3(2): 4-7.
[2]
Sen BK, Basu M, Das S, Chaturvedi AN. Unusual cause of spontaneous bilateral pneumothorax secondary to osteosarcoma metastasis. J Assoc Physicians India 2016; 64(2): 68-9.
[PMID: 27730786]
[3]
Fayda M, Kebudi R, Dizdar Y, Gorgun O, Gun F, Aksu G, et al. Spontaneous pneumothorax in children with osteosarcoma: report of three cases and review of the literature. Acta Chir Belg 2006; 24(18): 377-81.
[PMID: 23175928]
[4]
Hendarsih E, Fadjari TH, Oehadian A. Chemotherapy-induced spontaneous pneumothorax: case series. Acta Med Indones 2016; 48(2): 134-8.
[PMID: 27550883]
[5]
Oncel M, Sunam GS, Yıldıran H. Simultaneous bilateral secondary pneumothorax. Eur J Gen Med 2015; 12(1): 174-6.
[6]
Saadat A, Jafari NJ, Khedmat H, Jalalian HR. Spontaneous pneumothorax in a patient with osteosarcoma during treatment with methotrexate. Int J Pharmacol 2007; 3(2): 204-6.
[http://dx.doi.org/10.3923/ijp.2007.204.206]
[7]
Gan Z, Lin S, Han K, Shen Z, Yao Y, Min D. Bilateral spontaneous pneumothorax in an osteosarcoma patient with pulmonary metastases: A case report. Oncol Lett 2016; 11(2): 1179-80.
[http://dx.doi.org/10.3892/ol.2015.4010] [PMID: 26893715]
[8]
Amin Z. Tumor metastasis ke rongga toraks [Metastatic tumor to the thoracic cavity]. Ina J Chest Crit and Emerg Med 2014; 1(4): 187-9.
[9]
De Nazareth A, Gogineni V, Olivella J, Morrow L. Extraosseous osteosarcoma: an unusual cause of malignant pleural effusion and spontaneous pneumothorax. Chest 2011; 140(4): 5A.
[http://dx.doi.org/10.1378/chest.1119752]
[10]
Prater S, McKeon B. Osteosarcoma. Treasure Island (FL): StatPearls Publishing 2021. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549868/ Accessed on 23 November 2020
[11]
Chilvers J, Moore P. Spontaneous pneumothorax secondary to osteosarcoma metastasis. Anaesthesia 2002; 57(6): 620.
[http://dx.doi.org/10.1046/j.1365-2044.2002.265820.x] [PMID: 12010277]
[12]
Kuwal A, Dutt N, Chauhan NK, Pareek P, Saini LK, Samdariya S. Bilateral spontaneous pneumothorax in osteogenic sarcoma due to occult pulmonary metastases. Clin Cancer Investig J 2016; 5: 483-5.
[http://dx.doi.org/10.4103/2278-0513.197862]
[13]
Maniwa T, Nakagawa K, Isaka M, Ohde Y, Okumura T, Kondo H. Pneumothorax associated with treatment for pulmonary malignancy. Interact Cardiovasc Thorac Surg 2011; 13(3): 257-61.
[http://dx.doi.org/10.1510/icvts.2011.273201] [PMID: 21700592]
[14]
Foroulis CN. Surgery for primary spontaneous pneumothorax. J Thorac Dis 2016; 8(12): E1743-5.
[http://dx.doi.org/10.21037/jtd.2016.12.31] [PMID: 28149629]
[15]
Sarkar P, Chandak T, Shah R, Talwar A. Diagnosis and management bronchopleural fistula. Indian J Chest Dis Allied Sci 2010; 52(2): 97-104.
[PMID: 20578402]
[16]
Nakada T, Okumura S, Kuroda H, et al. Outcome of radical surgery for pulmonary metastatic osteosarcoma with secondary spontaneous pneumothorax: case series report. Ann Thorac Cardiovasc Surg 2014; 20(Suppl.): 574-7.
[http://dx.doi.org/10.5761/atcs.cr.12.02147] [PMID: 23518630]
[17]
Ng CSH, Lee TW, Wan S, Yin APC. Video-assisted thoracic surgery in spontaneous pneumothorax. Postgrad Med J 2006; 82(965): 179-85.
[http://dx.doi.org/10.1136/pgmj.2005.038398] [PMID: 16517799]
[18]
Le Garff G, Léna H, Corbineau F, Kerbrat P, Delaval P. Unusual cause of recurrent pneumothorax: excavated metastasis of osteosarcoma. Ann Thorac Surg 2001; 72(6): 2111-3.
[http://dx.doi.org/10.1016/S0003-4975(01)02694-7] [PMID: 11789805]
[19]
Lamb C, Li A, Thakkar D, Lee P. Pleurodesis. Semin Respir Crit Care Med 2019; 40(3): 375-85.
[http://dx.doi.org/10.1055/s-0039-1693997] [PMID: 31525812]
[20]
Kamal AF, Prabowo Y, Prayogo N, Ramli I, Nuhonni SA. Panduan penatalaksanaan osteosarcoma. Komite Penanggulangan Kanker Nasional [Guidelines for the management of osteosarcoma. National Cancer Management Committee]. Indonesia; 2015 Available from: http://kanker.kemkes.go.id/guidelines/backup/PNPKOsteosarkoma.pdf Accessed on 23 July 2020
[21]
Pandey M, Thomas BC. Rehabilitation of cancer patients. J Postgrad Med 2001; 47(1): 62-5.
[PMID: 11590299]
[22]
Stewart AG, Howard P. Indications for long-term oxygen therapy. Respiration 1992; 59(2)(Suppl. 2): 8-13.
[http://dx.doi.org/10.1159/000196113] [PMID: 1513974]
[23]
Davis P, O’Brien A, Donoghue N, Cronin A, Langan D, Cahill T, et al. Irish Guidelines on Long Term Oxygent Treatment (LTOT) in adults. Ireland; 2015 Available from: https://irishthoracicsociety.com/wp-content/uploads/2017/05/LTOT-guideline-2015-1.pdf Accessed on 23 July 2020