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Case Reports in Oncological Medicine
Volume 2012, Article ID 390702, 5 pages
Case Report

Axitinib Induced Recurrent Pneumothorax following Near-Complete Response of Renal Cell Carcinoma Lung Metastasis: An Unexpected Complication

Division of Hematology and Oncology, Department of Medicine, Jackson Memorial Hospital and Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Suite 3300, 1475 Northwest 12th Avenue, Miami, FL 33136, USA

Received 10 October 2012; Accepted 27 November 2012

Academic Editors: Y.-J. Chen, M. Ryberg, and R. Yamamoto

Copyright © 2012 Francisco Socola et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


We report a case of a Caucasian male with a history of renal cell carcinoma metastatic (mRCC) to the lungs refractory despite aggressive treatment with several lines of targeted therapy. He was started on axitinib palliative targeted therapy with a good clinical and radiological response; however one month after treatment initiation he presented to the emergency department with severe dyspnea and hypoxemia. Physical exam and chest X-ray revealed left-sided tension pneumothorax which required emergent thoracostomy with subsequent improvement; however it recurred requiring video assisted thoracoscopy. A left-sided 4 × 3 cm cavitated necrotic lesion was found at the level of the main pulmonary artery. Repair with pericardial fat flap was performed. Surgical biopsies from this lesion revealed mRCC with extensive necrosis. Imaging studies before and after axitinib use showed an initial 4 × 3 cm mass seen in the same location of this large cavitated necrotic tumor. Pneumothorax has not been described as a potential major complication from the use of axitinib. Complete or near-complete responses of mRCC to axitinib targeted therapy may lead to this potential life-threatening complication, particularly if the metastatic lesions are located near to pleural structures. We also review pertinent clinical trial data on axitinib.