A Case of Pneumothorax Following Radiation Therapy for Small Cell Lung Cancer in a Patient with Scleroderma-ILD

Connective tissue diseases, particularly scleroderma, pose a heightened risk for the development of malignancies such as breast and lung cancer. Stereotactic Body Radiation Therapy (SBRT) has emerged as an effective treatment modality for various cancers, including lung and breast cancers, due to its curative potential, especially for localized extracranial tumors. A 69-year-old patient with a 30-pack-year smoking history presented with shortness of breath and bilateral diffuse rales on chest auscultation during the outpatient clinic visit. Notably, the patient had not received scleroderma treatment for a year at the time of radiation therapy. Despite the recognized sensitivity of the lungs to radiotherapy, the occurrence of pneumothorax and pneumomediastinum following SBRT in this case raises concerns about the potential complications in scleroderma-ILD patients with lung cancer. This report underscores the need for comprehensive risk assessment and careful consideration of alternative treatment strategies for lung cancer in scleroderma patients, particularly those with pre-existing lung involvement. Further research is warranted to elucidate the mechanisms and risk factors associated with complications following radiotherapy in this patient population, guiding clinicians in optimizing therapeutic approaches for improved outcomes.