Pneumothorax during lenvatinib plus pembrolizumab for recurrent endometrial cancer: A case report

Pneumothorax is a rare adverse event in cancer treatment. Lenvatinib, a multi-kinase inhibitor with antiangiogenic activity, may cause organ perforation. We present a case of pneumothorax during lenvatinib plus pembrolizumab (LP) therapy for endometrial cancer.

A 63-year-old woman with stage 1A endometrioid adenocarcinoma underwent hysterectomy, bilateral adnexectomy, and pelvic lymphadenectomy, followed by radiation therapy. Owing to multiple lung and pleural metastases, she underwent thoracoscopic partial resection of the right lung, followed by adriamycin and cisplatin chemotherapy; however, the residual tumors still progressed. LP was then administered, and stable disease was obtained. Seven months after LP introduction, she presented with epigastric pain, thereafter diagnosed with right-lung pneumothorax. After chest tube placement and pleurodesis, lenvatinib was restarted at a reduced dose. Subsequently, the pneumothorax did not recur.

This case highlights the possibility of pneumothorax during LP therapy, especially in patients with lung metastases in contact with the pleura.