Hemopneumothorax and hemoperitoneum in a case with large cell carcinoma of the lung

  • Junichi Yoshida
  • Takashi Kajiwara
  • Motoichi Akao
  • Akira Tanimura
Case Report


Hemopneumothorax and hemoperitoneum coincide rarely in nontraumatic cases. Here, a 70-year-old male presented a left axillary lymph node and was diagnosed as having metastatic squamous cell carcinoma. Under the same diagnosis, another lesion developed in the right femur and was resected. One year later, computed tomography detected another tumor in the left adrenal gland. Shortly afterwards, left pneumothorax developed and a chest operation revealed hemopneumothorax due to a ruptured cavitary form of large cell carcinoma. The serum showed a human chorionic gonadotropin-β level of 1,100 ng/ml. At three-months later, he died of hemoperitoneum. The autopsy demonstrated hepatic metastases and a ruptured adrenal metastasis; microscopy showed marked trophoblastic and squamous cell changes in these organs. This patient was unique in that the rupture of the pulmonary and the adrenal lesions caused clinical manifestation.

Key words

pneumothorax large cell carcinoma in the lung trophoblast squamous cell 


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  1. 1.
    Wright FW. Spontaneous pneumothorax and pulmonary malignant disease: a syndrome sometimes associated with cavitating tumours. Report of nine new cases; four with metastases and five with primary bronchial tumours. Clin Radiol 1976; 27: 211–22.PubMedCrossRefGoogle Scholar
  2. 2.
    Tsukamoto T, Satoh T, Yamada K, Nagasawa M. Primary lung cancer presenting as spontaneous pneumothorax (Eng abstr). J Jpn Assn Thorac Surg 1995; 33: 936–9.Google Scholar
  3. 3.
    Laurens RG Jr, Pine JR, Honig EG. Spontaneous pneumothorax in primary cavitating lung carcinoma. Radiology 1983; 146: 295–7.PubMedGoogle Scholar
  4. 4.
    Abrams J, Talcott J, Corson JM. Pulmonary metastases in patients with low-grade endometrial stromal sarcoma. Clinicopathologic findings with immunohistochemical characterization. Am J Surg Pathol 1989; 13: 133–40.PubMedCrossRefGoogle Scholar
  5. 5.
    Takizawa T, Koike T, Akamatsu H. Successful treatment of hemopneumothorax with intrapleural OK432 in pulmonary metastases of cutaneous angiosarcoma (Eng abstr). Nippon Kyobu Shikkan Gakkai Zasshi 1995; 33: 1334–7.PubMedGoogle Scholar
  6. 6.
    Hihara T, Furumoto N, Kakishita M. Hemopneumothorax due to pulmonary metastasis with malignant hemangioendothelioma: CT and pathological findings. Radiat Med 1988; 6: 213–5.PubMedGoogle Scholar
  7. 7.
    Nomura M, Nakaya Y, Saito K, Miyoshi H, Kishi F, Hibino S, et al. Hemopneumothorax secondary to multiple cavitary metastasis in angiosarcoma of the scalp. Respiration 1994; 61: 109–12.PubMedCrossRefGoogle Scholar
  8. 8.
    Mittleman RE. Hepatic rupture due to metastatic lung carcinoma. Am J Clin Pathol 1987; 88: 506–9.PubMedGoogle Scholar
  9. 9.
    Nelson BE, Carcangiu ML, Chambers JT. Intraabdominal hemorrhage with pulmonary large cell carcinoma metastatic to the ovary. Gynecol Oncol 1992; 47: 377–81.PubMedCrossRefGoogle Scholar
  10. 10.
    Yoshida J, Nakano T, Akao M, Tanimura A. Pneumothorax due to hemangiopericytoma metastasis from the thigh. Jpn J Thorac Cardiovasc Surg 1998; 46: 523–5.PubMedGoogle Scholar

Copyright information

© The Japanese Society of Thoracic and Cadiovascular Surgery 2000

Authors and Affiliations

  • Junichi Yoshida
    • 1
  • Takashi Kajiwara
    • 1
  • Motoichi Akao
    • 1
  • Akira Tanimura
    • 1
    • 2
  1. 1.Division of Chest SurgeryShimonoseki City HospitalShimonosekiJapan
  2. 2.Division of PathologyShimonoseki City HospitalShimonosekiJapan

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