Q: 58 years old male presented to ED with acute chest pain and shortness of breath (SOB). Chest-X-ray revealed spontaneous pneumothorax (SPS). Subsequent workup led to the diagnosis of cancer. SPS is more in (select one)
A) Primary lung tumor
B) Metastatic lung tumor
Answer: A
Although SPS can occur in either primary or metastatic lung cancer, it is more common in primary lung tumors. SPS occurs in lung cancer due to tumor necrosis, endobronchial obstruction, necrotizing cysts, pneumonia, and coexisting emphysema.
Malignancies that metastasize to lungs cause necrotic cysts, resulting in SSP. The most common tumors are lymphoma, sarcoma, GI or GU adenocarcinoma, mesenchymal cystic hamartoma, pleuropulmonary blastoma, and angiosarcoma.
#oncology
#pulmonary
References:
1. Choi YK, Kim KC. Spontaneous pneumothorax as the first manifestation of lung cancer: two case report. J Thorac Dis. 2015;7(8):E252-E254. doi:10.3978/j.issn.2072-1439.2015.07.31
2. Okada D, Koizumi K, Haraguchi S, Kawamoto M, Mikami I, Tanaka S. Pneumothorax manifesting primary lung cancer. Jpn J Thorac Cardiovasc Surg. 2002 Mar;50(3):133-6. doi: 10.1007/BF02913477. PMID: 11968723.
3. Steinhäuslin CA, Cuttat JF. Spontaneous pneumothorax. A complication of lung cancer? Chest. 1985 Nov;88(5):709-13. doi: 10.1378/chest.88.5.709. PMID: 2996838.
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