[A case of interstitial lung disease due to sunitinib].
A 64-year-old Japanese man who presented with a left renal mass (diameter, 9 cm) and multiple lung metastases, underwent translumbar left radical nephrectomy. Histological examination revealed the presence of clear cell-type, G3, pT3b renal cell carcinoma. Interferon-alpha (IFN-α) was administered postoperatively. Although the lung metastases were well controlled, radiological examination showed right renal metastasis and multiple brain metastases. γKnife was performed and chemotherapy was changed to sunitinib (50 mg/day). The patient developed a high fever on day 13 ; therefore, sunitinib administration was stopped on day 15. The next day, he presented with dyspnea, and chest computed tomography (CT) showed diffuse ground-glass opacities in both lungs. Bronchioalveolar lavage showed a predominance of lymphocytes, without any evidence of infection. We diagnosed the patient with interstitial lung disease (grade 3) attributable to sunitinib administration. After cessation of sunitinib therapy, chest CT showed that the shadows had resolved. We administered half of the previous dose of sunitinib 2 weeks after cessation of sunitinib therapy for complete resolution of the lung metastases. After the 2nd course of sunitinib, radiological examination showed tumor progression. Therefore, we replaced sunitinib with everolimus. Interstitial lung disease due to sunitinib therapy may be rare ; however, its occurrence should be considered when administering sunitinib.
The Department of Urology, Yokohama City Minato Red Cross Hospital, Japan.
Zenkichi
Z
Sekiguchi
Akitoshi
A
Takizawa
Teppei
T
Takeshima
Futoshi
F
Tsuchiya
Akira
A
Iwasaki
Shunichi
S
Matsuyama
Nobukazu
N
Hirooka
D000970:Antineoplastic Agents / Q000009:adverse effects*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D007211:Indoles / Q000009:adverse effects*; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000473:pathology; D017563:Lung Diseases, Interstitial / Q000139:chemically induced* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011758:Pyrroles / Q000009:adverse effects*; D000077210:Sunitinib
D000970:Antineoplastic Agents; D007211:Indoles; D011758:Pyrroles; D000077210:Sunitinib