Pulmonary veno-occlusive disease after neoadjuvant mitomycin chemotherapy and surgery for lung carcinoma.
Pulmonary veno-occlusive disease (PVOD), an uncommon cause of pulmonary hypertension (PH) has been reported following treatment of a variety of different malignancies with various chemotherapy. We report here the cases of two patients with non-small cell lung cancer (NSCLC) who developed fatal PH after combined treatment with surgery and a mitomycin containing perioperative chemotherapy (PCT). PVOD was documented at autopsy in one patient and was strongly suspected in the other patient who had an identical clinical presentation and in whom the work-up looking for another cause of PH was negative. Mitomycin was incriminated in both cases. Without questioning the potential interest of perioperative chemotherapy in resectable NSCLC, these observations illustrate the risks related to the combination of pneumotoxic chemotherapy and thoracic surgery.
Gagnadoux
F
F
Department of Pulmonary Medicine, Saint-Antoine Hospital, 184 rue du fg Saint-Antoine, 75571 Cedex 12, Paris, France. frederic.gagnadoux@sat.ap-hop-paris.fr
Capron
F
F
Lebeau
B
B
D000903:Antibiotics, Antineoplastic / Q000009:adverse effects* / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000628:therapy*; D003131:Combined Modality Therapy; D004452:Echocardiography; D004562:Electrocardiography; D017809:Fatal Outcome; D006801:Humans; D006976:Hypertension, Pulmonary / Q000139:chemically induced; D008175:Lung Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000009:adverse effects* / Q000627:therapeutic use; D011668:Pulmonary Veno-Occlusive Disease / Q000139:chemically induced*
D000903:Antibiotics, Antineoplastic; D016685:Mitomycin