Bullous change by CT heralding metastatic sarcoma

The association of spontaneous pneumothorax with metastatic osteosarcoma is well known. Small blebs and bullous change can be easily detected in the lungs by computed tomography. In patients with known sarcomas, blebs and bullae may appear as the first or early manifestation of metastatic disease (or concurrent with the disease) as illustrated by the three patients presented here with three different types of sarcomas. The literature has been reviewed as to the etiology of spontaneous pneumothoraces occurring in metastatic sarcomas and the relationship of bleb and bullae formation to these spontaneous pneumothoraces is discussed.