Metastatic sarcomas to lung have been long recognized as a cause of pneumothorax. The frequency and effect on longevity of its occurrence has not been defined.
Retrospective review of 2444 consecutive tumor patients admitted to our hospital between Jan 1990 and Sept 2000 identified 1348 cases with confirmed diagnosis followed a minimum of 28 days in whom radiological examination of the chest was available. Data abstracted for patient demographics, histological diagnosis, presence of pulmonary metastasis, and survival, was compared with admission prevalence, and subsequent occurrence of pneumothorax.
All 10 pneumothoraces occurred in the 311 patients with primary bone and soft tissue sarcomas: incidence 1.2 % / year. Three patients had pneumothorax at first hospital admission with two of these being bilateral simultaneous occurrences for a prevalence 2.4% at admission.The 201 sarcoma patients with pulmonary metastases had all but one of the pneumothoraces (9 / 391 pt yr.; incidence 2.3%/yr.). Only one patient with an osteosarcoma had no computerized tomographic evidence of pulmonary metastases. He remained free of evidence of metastases during 8 months of follow up.No patient died as a result of pneumothorax. The timing of pneumothorax bore no relationship to chemotherapy. Survival for patients with pneumothorax was equal to the group with metastases as a whole with mean survival 39 months.
Pneumothorax is an uncommon complication of bone and soft tissue sarcomas metastatic to lung. It’s poor prognosis is reflects the prognosis of the underlying metastasis.
Prevalence at admission and incidence of pneumothorax secondary to metastatic sarcoma is infrequent and bears the negative prognostic effect of the underlying tumor.
T.A. Horan, None.