Interstitial pneumonitis following intrapleural chemotherapy.
BACKGROUND
Mucinous neoplasms within the abdomen may disseminate by direct extension through the diaphragm to involve the pleural space. Treatment of this condition is by parietal and visceral pleurectomy followed by hyperthermic intrapleural chemotherapy.


METHODS
In this case report a patient developed persistent right upper lobe interstitial pneumonitis and progressive parenchymal fibrosis following intrapleural chemotherapy treatment with mitomycin C and doxrubicin. The condition persisted until death 28 months later. Death was from progressive intraabdominal disease with intestinal obstruction and sepsis associated with progressive pulmonary parenchymal disease. The right pleural space disease did not recur.


CONCLUSIONS
This manuscript is the first case report describing interstitial pneumonitis and lung fibrosis following intrapleural chemotherapy. Since pulmonary toxicity from chemotherapy is a dose-dependent phenomenon, dose reduction of intrapleural as compared to intraperitoneal hyperthermic chemotherapy may be necessary.
Zappa
Luis
L
Program in Peritoneal Surface Malignancy, Washington Cancer Institute, Washington, DC, USA. lzwdc@yahoo.com
Savady
Renaldo
R
Humphries
Gary N
GN
Sugarbaker
Paul H
PH
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000008:administration & dosage; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D017563:Lung Diseases, Interstitial / Q000139:chemically induced* / Q000473:pathology; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D010997:Pleural Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000628:therapy; D011013:Pneumonectomy; D011658:Pulmonary Fibrosis / Q000139:chemically induced* / Q000473:pathology; D014057:Tomography, X-Ray Computed
D016685:Mitomycin; D004317:Doxorubicin