A Case of Secondary Pneumothorax due to Pleomorphic Carcinoma of the Lung with a Cavitary Lesion

Abstract

A 43-year-old man had been treated for smoking cessation with varenicline because he was aware of left chest pain and dyspnea with movement. When he came to our office for worsening of the symptoms and complained of severe dyspnea, a chest radiograph showed pneumothorax. A chest CT scan after chest drainage revealed a mass with a cavitary lesion and bulla in the left upper lobe. Air leak persisted even after the placement of a thoracic drain. There was no evidence of tuberculosis and mycosis. We diagnosed the case as secondary pneumothorax complicated by primary lung cancer and performed left upper lobectomy. Based on histological examinations, pleomorphic carcinoma (pT2bN2 cM0, Stage IIIA) was diagnosed. Although there are some case reports on pneumothorax due to cystic lesions adjacent to tumors and development of pneumothorax during chemotherapy containing a molecular target drug, secondary pneumothorax due to cavitary lung cancer is rare. We report a case of secondary pneumothorax due to ruptured cavitary pleomorphic carcinoma.