Simultaneous Bilateral Spontaneous Pneumothorax: A Rare Complication of Osteosarcoma

Tariq, Usman; Sohail, Muhammad Saad; Fatima, Zainab; Khan, Amina; Sheikh, Abu Baker

doi:10.7759/cureus.2745

Cited by 9 publications

(21 citation statements)

References 11 publications

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Section: Discussionmentioning

confidence: 99%

“…The incidence of pneumothorax in this study (phase I/II; 11%) is similar to that for other TKIs (3%-16%), and is consistent with the prevalence observed in patients with relapsed/refractory osteosarcoma. 17,25,30,[32][33][34][35][36][37] Our study was limited by the enrollment of only one patient with RR-DTC. Therefore, no conclusions can be drawn about the activity of lenvatinib in RR-DTC.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Phase I/II study of single-agent lenvatinib in children and adolescents with refractory or relapsed solid malignancies and young adults with osteosarcoma (ITCC-050)☆

et al. 2021

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Background We report results from the phase I dose-finding and phase II expansion part of a multicenter, open-label study of single-agent lenvatinib in pediatric and young adult patients with relapsed/refractory solid tumors, including osteosarcoma and radioiodine-refractory differentiated thyroid cancer (RR-DTC) ( NCT02432274 ). Patients and methods The primary endpoint of phase I was to determine the recommended phase II dose (RP2D) of lenvatinib in children with relapsed/refractory solid malignant tumors. Phase II primary endpoints were progression-free survival rate at 4 months (PFS-4) for patients with relapsed/refractory osteosarcoma; and objective response rate/best overall response for patients with RR-DTC at the RP2D. Results In phase I, 23 patients (median age, 12 years) were enrolled. With lenvatinib 14 mg/m 2 , three dose-limiting toxicities (hypertension, n = 2; increased alanine aminotransferase, n = 1) were reported, establishing 14 mg/m 2 as the RP2D. In phase II, 31 patients with osteosarcoma (median age, 15 years) and 1 patient with RR-DTC (age 17 years) were enrolled. For the osteosarcoma cohort, PFS-4 (binomial estimate) was 29.0% [95% confidence interval (CI) 14.2% to 48.0%; full analysis set: n = 31], PFS-4 by Kaplan–Meier estimate was 37.8% (95% CI 20.0% to 55.4%; full analysis set) and median PFS was 3.0 months (95% CI 1.8-5.4 months). The objective response rate was 6.7% (95% CI 0.8% to 22.1%). The patient with RR-DTC had a best overall response of partial response. Some 60.8% of patients in phase I and 22.6% of patients in phase II (with osteosarcoma) had treatment-related treatment-emergent adverse events of grade ≥3. Conclusions The lenvatinib RP2D was 14 mg/m 2 . Single-agent lenvatinib showed activity in osteosarcoma; however, the null hypothesis could not be rejected. The safety profile was consistent with previous tyrosine kinase inhibitor studies. Lenvatinib is currently being investigated in osteosarcoma in combination with chemotherapy as part of a randomized, controlled trial ( NCT04154189 ), in pediatric solid tumors in combination with everolimus ( NCT03245151 ), and as a single agent in a basket study with enrollment ongoing ( NCT04447755 ).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Phase I/II study of single-agent lenvatinib in children and adolescents with refractory or relapsed solid malignancies and young adults with osteosarcoma (ITCC-050)☆

et al. 2021

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“…[7][8][9][10][11][12] Pneumothorax and tumor-bronchial fistula are rare complications of pulmonary metastasis of osteosarcoma. [3][4][5][13][14][15][16] There are few reports about the complication, and the etiology remains unclear. The suspected etiologies of pneumothorax are as follows: (1) rupture of tumor tissue at the lung periphery; (2) a check valve mechanism, due to intermittent bronchiolar obstruction by tumor tissue; and (3) direct metastasis to a pulmonary cystic lesion.…”

Section: Discussionmentioning

confidence: 99%

“…Pneumothorax caused by metastasis is reported to account for <2% of all spontaneous pneumothorax cases 1,2. Recently, however, reports about patients with pneumothorax after the initiation of chemotherapy, or targeted biological agents, including antiangiogenic agents, have increased 3–5. Interiano et al3 reported a high incidence of pneumothorax in pediatric sarcoma patients who had received antiangiogenic agents.…”

mentioning

confidence: 99%

Surgical Treatment for Pneumothorax and Tumor-bronchial Fistula Secondary to Pulmonary Metastasis of Osteosarcoma in Pediatric and Adolescent Patients

Kawakubo¹,

Hishiki²,

Arakawa³

et al. 2022

Journal of Pediatric Hematology/Oncology

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Background: Pneumothorax and tumor-bronchial fistula are rare complications of pulmonary metastasis of osteosarcoma. Observations: We herein report the cases of 3 pediatric and adolescent patients who developed pneumothorax or tumor-bronchial fistula during treatment of pulmonary metastasis of osteosarcoma with chemotherapeutics or antiangiogenic agents. Two patients developed pneumothorax, and the other patient developed tumor-bronchial fistula. All of the patients finally underwent the surgery to treat their complications. Conclusions: Although it is not a curative surgery, surgery for pneumothorax and tumor-bronchial fistula is acceptable. The operative procedure should be considered on the basis of the predicted prognosis of the patient.

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“…3 The first patient was described by De Barrin in 1937. 4 Tariq et al 15 reported a case of simultaneous bilateral spontaneous pneumothorax in a young patient with fibular osteosarcoma. Gan et al 16 described a similar case of a patient with osteosarcoma of the right mandible who developed bilateral pneumothorax.…”

Section: Discussionmentioning

confidence: 99%

Bilateral pneumothorax after general anesthesia in patient with pleomorphic sarcoma of soft tissue

Gianesello

Boccaccini

Rostagno

2019

SAGE Open Medical Case Reports

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The occurrence of a pneumothorax using supraglottic device is a rare complication during general anesthesia. Moreover, less than 2% of pneumothoraxes can be related to lung metastases, most due to soft tissue sarcoma. We present the case of a 45-year-old female diagnosed with metastatic sarcoma who developed a bilateral pneumothorax after general anesthesia with supraglottic device. Different causes of pneumothorax were discussed.

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Simultaneous Bilateral Spontaneous Pneumothorax: A Rare Complication of Osteosarcoma

Cited by 9 publications

References 11 publications

Phase I/II study of single-agent lenvatinib in children and adolescents with refractory or relapsed solid malignancies and young adults with osteosarcoma (ITCC-050)☆

Phase I/II study of single-agent lenvatinib in children and adolescents with refractory or relapsed solid malignancies and young adults with osteosarcoma (ITCC-050)☆

Surgical Treatment for Pneumothorax and Tumor-bronchial Fistula Secondary to Pulmonary Metastasis of Osteosarcoma in Pediatric and Adolescent Patients

Bilateral pneumothorax after general anesthesia in patient with pleomorphic sarcoma of soft tissue

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