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Mitomycin induced pulmonary veno-occlusive disease

Afua Kunadu1, J Stephen Stalls2, Heloise Labuschagne1

  • 1Division of Pulmonary, Critical Care and Sleep Medicine, USA.

Respiratory Medicine Case Reports
|August 17, 2021
PubMed

Insights

Pulmonary veno-occlusive disease (PVOD) is a rare condition linked to Mitomycin-C (MMC) chemotherapy. This case highlights MMC-induced PVOD in a patient with anal cancer, emphasizing diagnostic methods and limited treatment options.

Area of Science:

  • Oncology
  • Pulmonary Medicine
  • Pharmacology

Background:

  • Pulmonary veno-occlusive disease (PVOD) is a rare cause of pulmonary hypertension (PH) involving pulmonary venule remodeling.
  • Mitomycin-C (MMC), an alkylating agent used in chemotherapy, is associated with lung toxicity and PVOD.
  • PVOD incidence is notably higher in anal cancer patients, particularly after MMC treatment.

Observation:

  • Diagnosis of PVOD can be achieved through noninvasive methods.
  • Key diagnostic indicators include oxygen parameters, reduced diffusing capacity for carbon monoxide, and high-resolution CT findings.
  • A case of autopsy-confirmed MMC-induced PVOD in a patient with metastatic anal cancer is presented.

Findings:

  • MMC is a potential cause of PVOD, especially in specific cancer patient populations.
  • Noninvasive investigations are effective for diagnosing PVOD.
  • Currently, no evidence-based medical therapies exist for PVOD.

Implications:

  • This case underscores the importance of recognizing MMC-induced PVOD in anal cancer patients.
  • Early diagnosis through noninvasive methods is crucial.
  • Lung transplantation remains the primary definitive treatment for eligible PVOD patients.
Keywords:
Anal cancerMitomycin-CPulmonary arterial hypertensionPulmonary hypertensionPulmonary vasodilatorsPulmonary veno-occlusive diseaseRespiratory failure

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