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Tae, Lee, Kim, Sim, Lee, Noh, Park, Ryu, Chun, and Chang: Acute Respiratory Distress Syndrome after Topotecan Therapy in a Patient with Small Cell Lung Cancer
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2008; 65(2): 142-146.

Published online: 31 August 2008

DOI: https://doi.org/10.4046/trd.2008.65.2.142

Acute Respiratory Distress Syndrome after Topotecan Therapy in a Patient with Small Cell Lung Cancer

Jung Hyun Tae, M.D.1, Jin Hwa Lee, M.D.1, Yoon Kyung Kim, M.D.2, Yun Su Sim, M.D.1, Kyung Jong Lee, M.D.1, Young Wook Noh, M.D.1, Jae Jung Park, M.D.1, Yon Ju Ryu, M.D.1, Eun Mi Chun, M.D.1, Jung Hyun Chang, M.D.1

1Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.

2Department of Radiology, Ewha Womans University School of Medicine, Seoul, Korea.

Address for correspondence: Jin Hwa Lee, M.D., Ph.D. Department of Internal Medicine, Ewha Womans University School of Medicine, 911-1, Mok-dong, Yancheon-gu, Seoul 158-710, Korea. Phone: 82-2-2650-6007, Fax: 82-2-2655-2076, jinhwalee@ewha.ac.kr

Received 27 May 2008       Accepted 8 July 2008

Copyright © 2008 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Small cell lung cancer is characterized by an aggressive clinical course and a high tendency for early dissemination in spite of a good chemotherapy response. Topotecan is a topoisomerase I inhibitor, and it is used as second-line treatment for small cell lung cancer. The reported dose-limiting adverse reactions to topotecan are mainly hematologic. Yet pulmonary toxicity associated with topotecan is known to be rare. We report here on a case that showed the development of acute respiratory distress syndrome during the 3rd cycle of topotecan chemotherapy in a patient with small cell lung cancer. He developed dyspnea and respiratory failure, and the chest CT scan revealed diffuse ground-glass opacity that was probably due to chemotherapy-related pulmonary toxicity. He finally died of acute respiratory distress syndrome.

Keywords: Small cell carcinoma, Topotecan, Acute respiratory distress syndrome

Figures and Tables

Figure 1
Chest radiograph on admission shows the left upper lobe mass and left pleural effusion (A). Chest radiograph after 3rd topotecan therapy shows diffuse ground-glass opacities in the right lung (B).
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Figure 2
Chest CT scan prior to topotecan therapy shows lung cancer of left upper lobar bronchus and radiation pneumonitis (A). Chest CT on the 7th hospital day scan shows newly appeared diffuse ground-glass opacities in the right lung (B).
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Figure 3
Chest radiograph on the 12th hospital day shows aggravated diffuse ground-glass opacities in both lungs.
trd-65-142-g003

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