Cryptogenic organizing pneumonia after radiotherapy for breast cancer

We report a case of fever, dyspnea, respiratory failure and migratory, recurrent and bilateral lung opacities 4 months after radiotherapy and hormone therapy following surgery for breast cancer. Computerized tomography (CT) scans showed infiltrates outside the radiation fields. Bronchoalveolar lavage revealed lymphocytic alveolitis, whereas laboratory analysis demonstrated a mild systemic inflammation. Systemic steroids resulted in clinical and radiological improvement, but a disease relapse was evident at withdrawal of therapy, with definitive clinical and radiological normalization after a second cycle of therapy. This is a case of cryptogenic organizing pneumonia (COP) (previously known as bronchiolitis obliterans organizing pneumonia) primed by radiotherapy, as in previously reported cases. It is extremely important to be aware of the possibility of this complication, in order to optimize radiation and hormone treatment of breast cancer.