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Small cell lung carcinoma presenting initially with recurrent pneumothoraces: a case report.
John Buchanan1, Mohamed Shatila2,3, Ashvini Menon2
1University of Birmingham Medical School, Edgbaston, Birmingham, B15 2TT, West Midlands, UK.
Journal of Cardiothoracic Surgery
|June 21, 2024
Summary
Spontaneous pneumothorax is a rare presentation of small cell lung carcinoma (SCLC). This case highlights the importance of considering SCLC in patients with recurrent pneumothorax, even with no initial signs of metastasis.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Oncology
Background:
- Pneumothorax, an abnormal air collection in the pleural space, is categorized as primary, secondary, or traumatic.
- Lung cancer, particularly non-small cell lung carcinoma (NSCLC), can cause secondary pneumothorax, but presentation with small cell lung carcinoma (SCLC) is exceptionally rare.
Observation:
- A 62-year-old male with a history of COPD and smoking presented with recurrent spontaneous pneumothorax.
- Initial management included chest drain insertion; subsequent VATS bullectomy and talc pleurodesis were performed.
- Pathology confirmed SCLC with extensive infiltration, despite no gross metastatic spread on CT scans.
Findings:
- This case represents an exceedingly rare presentation of SCLC manifesting as spontaneous pneumothorax.
- The patient underwent adjuvant chemotherapy with carboplatin and etoposide due to R1 resection and high recurrence risk.
Implications:
- Pneumothorax as an initial presentation of lung cancer is associated with a poor prognosis, though underlying reasons remain unclear.
- Further research is needed to understand the mechanisms of spontaneous pneumothorax in lung cancer patients.
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