Abstract
Background. Pneumatosis cystoides intestinalis (PCI) is a relatively uncommon disease characterized by the development of emphysematous cysts beneath the serosa and mucosa of the intestines. One of the reported types of PCI is "drug-induced"; however, there are few case reports of this condition developing during chemotherapy for lung cancer. Case. An 83-year-old male was treated with amrubicin as second-line therapy for small-cell lung cancer (cT4N3M1b: Stage IV). He developed diarrhea on the 7th day after the initiation of therapy and grade 3 neutropenia on the 9th day of therapy. On the 10th day, he complained of abdominal distension, and a chest X-ray showed the presence of free gas under the right diaphragm. An abdominal CT scan revealed free gas in the abdomen and gas in the wall of the ileum. We diagnosed the patient with PCI and chose conservative therapy because a physical examination did not reveal any signs of peritonitis. Subsequently, a marked improvement of the abdominal distension was observed on the 14th day. A follow-up abdominal CT scan performed on the 15th day showed almost a complete resolution of the extraintestinal free gas and gas in the wall of the ileum. No recurrence of PCI was observed following repeat treatment with amrubicin. Conclusions. This case highlights the fact that PCI can develop during chemotherapy for lung cancer. Clinicians should be cognizant of the possibility of PCI in patients who develop abdominal symptoms after the start of chemotherapy.
