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Tension Pneumothorax: Is it Sarcoma or Pazopanib?
Vinoja Sebanayagam1, Samer Alkassis2, Bayan Alshare1
1Hematology and Oncology, Wayne State University School of Medicine, Detroit, USA.
Cureus
|November 17, 2020
Summary
Synovial sarcoma, a rare cancer, can lead to pneumothorax. This case explores if pazopanib treatment or lung metastases caused pneumothorax in a patient with synovial sarcoma.
Area of Science:
- Oncology
- Pulmonology
- Medical Science
Background:
- Synovial sarcoma is a rare malignancy originating from mesenchymal stem cells.
- Lung and pleural metastases are common in sarcomas, occurring in up to 85% of cases.
- Spontaneous pneumothorax is an infrequent complication in sarcoma patients (1.9%), with synovial sarcoma being a notable association.
Observation:
- A patient with trapezius-origin synovial sarcoma and lung metastases developed pneumothorax after initiating pazopanib therapy.
- Pazopanib is a targeted therapeutic agent used when chemotherapy fails for metastatic disease.
- Previous studies have suggested a link between pazopanib and pneumothorax, but a causal association remains statistically unproven.
Findings:
- Pneumothorax can arise from lung metastases independently of treatment side effects.
- Distinguishing between treatment-induced pneumothorax and disease progression is crucial for patient management.
- This case highlights the complexity of attributing pneumothorax to either pazopanib or underlying metastatic disease.
Implications:
- Understanding the etiology of pneumothorax in sarcoma patients is vital for clinical decision-making.
- The findings emphasize the need for careful monitoring of patients on targeted therapies like pazopanib.
- Further research is needed to clarify the relationship between pazopanib, lung metastases, and pneumothorax in synovial sarcoma.
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