Journal of the Formosan Medical Association
Volume 108, Issue 9 , Pages 736-738, September 2009

Lingual Carcinoma Metastases Presenting as Spontaneous Pneumothorax

  • Jui-Sheng Hsu

      Affiliations

    • Department of Medical Imaging, Kaohsiung Medical University, Tainan, Taiwan
    • Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Tainan, Taiwan
    • Department of Medical Imaging, Kaohsiung Medical University, Tainan, Taiwan
    • ,
  • Shah-Hwa Chou

      Affiliations

    • Division of Thoracic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Tainan, Taiwan
    • ,
  • Kun-Bow Tsai

      Affiliations

    • Department of Pathology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
    • ,
  • Ming-Tsung Chuang

      Affiliations

    • Department of Medical Imaging, Kaohsiung Medical University, Tainan, Taiwan
    • Department of Diagnostic Radiology, National Cheng-Kung University Hospital, Tainan, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Ming-Tsung Chuang, Department of Diagnostic Radiology, National Cheng-Kung University Hospital, 138 Sheng-Li Road, Tainan 704, Taiwan

Received 13 September 2007; received in revised form 21 January 2008; accepted 14 March 2008.

Article Outline

Spontaneous pneumothorax is a rare manifestation of primary lung cancer or metastasis. We report a 39-year- old man with well-differentiated squamous cell carcinoma of the tongue and cervical lymph node metastases. He developed lung metastases and spontaneous pneumothorax 22 months later after intra-arterial infusion chemotherapy. The patient was managed with partial lung resection under thoracotomy. The pneumothorax resolved completely after the operation. Histological examination demonstrated metastatic squamous cell carcinoma, which had led to a bronchopleural fistula with subsequent induction of pneumothorax. The patient recovered uneventfully and continued to receive adjuvant chemotherapy in the oncology surgery outpatient department. Unfortunately, the tumors of the tongue and cervical lymph nodes progressively enlarged despite treatment. Eventually, the patient died of respiratory failure 5 months later. In most of the previously reported cases, pulmonary metastases associated with spontaneous pneumothorax usually originate from osteogenic or soft-tissue sarcomas. Although rare, pulmonary metastasis should be considered in the etiology of spontaneous pneumothorax. Despite advanced disease, surgical treatment may be feasible.

Key Words:  fistula , pneumothorax , thoracoscopy

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PII: S0929-6646(09)60398-3

doi:10.1016/S0929-6646(09)60398-3

Journal of the Formosan Medical Association
Volume 108, Issue 9 , Pages 736-738, September 2009

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