Pleural cavitations and pneumothorax following axitinib therapy in metastatic renal cell carcinoma: A case report

Feride Yılmaz, Serkan Yaşar, Figen Demirkazık, Zafer Arık, Mustafa Erman
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Abstract

Background

Tumor cavitation and pneumothorax are uncommon yet serious complications of antiangiogenic therapies. These risks are particularly significant in patients with metastatic renal cell carcinoma (mRCC). Axitinib, a selective inhibitor of vascular endothelial growth factor receptors (VEGFRs), is generally used as a second-line treatment for mRCC. However, rare cases of lung metastases with cavitary lesions and pneumothorax have been reported after the use of axitinib. Therefore, we decided to report one of these rare cases.

Case presentation

A 46-year-old male with mRCC developed pleural cavitations and secondary pneumothorax after starting axitinib therapy. Despite intensive management, his condition worsened with recurrent pneumothorax, ultimately leading to sepsis and multiorgan failure.

Conclusion

This case underscores the potential risks of tumor cavitation-induced pneumothorax in patients receiving axitinib. Close radiological monitoring and timely intervention are essential for reducing morbidity and mortality in such cases. Clinicians should remain vigilant for this rare but serious complication during axitinib therapy.

Abstract Image

转移性肾细胞癌阿西替尼治疗后胸腔空化和气胸1例
背景肿瘤空化和气胸是抗血管生成治疗的罕见但严重的并发症。这些风险在转移性肾细胞癌(mRCC)患者中尤为显著。阿西替尼是一种血管内皮生长因子受体(VEGFRs)的选择性抑制剂,通常用作mRCC的二线治疗。然而,在使用阿西替尼后,有罕见的肺转移伴空洞病变和气胸的病例报道。因此,我们决定报告其中一个罕见的病例。病例介绍:一名46岁男性mRCC患者在开始阿西替尼治疗后出现胸膜空腔和继发性气胸。尽管进行了强化治疗,他的病情仍因复发性气胸而恶化,最终导致败血症和多器官衰竭。结论本病例强调了阿西替尼患者发生肿瘤空化性气胸的潜在风险。密切的放射监测和及时干预对于降低此类病例的发病率和死亡率至关重要。临床医生应该对阿西替尼治疗期间这种罕见但严重的并发症保持警惕。
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