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Vol.52 No.7 contents | Japanese/English |
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- Case Report -
A Case of Pulmonary Sarcomatoid Carcinoma with Pneumothorax After Bevacizumab-combined Chemotherapy
Airi Kodama1, Mihoko Doi2, Kousuke Hamai2, Masamoto Funaki1, Masakazu Kamitsuna1, Masao Doi11Department of Respiratory Medicine and Rheumatology, 2Department of Clinical Oncology Medicine, Hiroshima Prefectural Hospital, Japan
Background. Pneumothorax is a rare complication of chemotherapy for patients with primary lung cancer. Case. A 73-year-old man was found to have an abnormal shadow directly under the pleura of the left upper lung field on an annual medical checkup. A chest CT scan showed an increase in the tumor in the left chest wall and mediastinal lymphadenopathy 2 years later. Thoracoscopic lung biopsy revealed a sarcomatoid carcinoma. Stage IV (T2aN3M1a) lung cancer was diagnosed by systematic examination. We administered systemic chemotherapy consisting of carboplatin and paclitaxel with bevacizumab as first-line chemotherapy, which proved to be effective. After 3 chemotherapy cycles, pneumothorax was detected. Therefore, a regimen consisting of carboplatin and paclitaxel without bevacizumab was given in the subsequent fourth cycle. As the tumor increased in size after the fourth cycle, it was treated with pemetrexed as second-line chemotherapy, but this treatment was not effective after 3 cycles. We thus selected a regimen consisting of S-1 combined with bevacizumab as third-line chemotherapy. At present, no pneumothorax recurrence and tumor enlargement have been observed after 6 chemotherapy cycles. Conclusion. Bevacizumab-combined chemotherapy was effective for pulmonary sarcomatoid carcinoma, but it induced secondary pneumothorax following tumor reduction. After recovery from the pneumothorax, tumor recurrence was not observed with the reuse of bevacizumab and tumor growth was inhibited.
key words: Pulmonary carcinoma, Sarcomatoid carcinoma, Bevacizumab, Pneumothorax
Received: March 28, 2012
Accepted: November 29, 2012
JJLC 52 (7): 1041-1046, 2012
