Mitomycin induced pulmonary veno-occlusive disease

Afua Kunadu; J Stephen Stalls; Heloise Labuschagne; Abdullah Thayyil; Randall Falls; Veeranna Maddipati

doi:10.1016/j.rmcr.2021.101437

Mitomycin induced pulmonary veno-occlusive disease

Respir Med Case Rep. 2021 Jun 1:34:101437. doi: 10.1016/j.rmcr.2021.101437. eCollection 2021.

Authors

Afua Kunadu¹, J Stephen Stalls², Heloise Labuschagne¹, Abdullah Thayyil², Randall Falls², Veeranna Maddipati¹

Affiliations

¹ Division of Pulmonary, Critical Care and Sleep Medicine, USA.
² Department of Pathology, East Carolina University, Greenville, North Carolina 27858, USA.

Abstract

Pulmonary veno-occlusive disease (PVOD) is a rare but devastating cause of pulmonary hypertension (PH) characterized by preferential remodeling of the pulmonary venules. Mitomycin-C (MMC) is an alkylating agent commonly used in chemotherapy with documented lung toxicity as well as PVOD adverse effect. The incidence of PVOD in patients with anal cancer is much higher than in those with idiopathic PVOD, especially following treatment with MMC. An accurate diagnosis of PVOD can be made based on noninvasive investigations utilizing oxygen parameters, low diffusing capacity for carbon monoxide and characteristic signs on high-resolution computed tomography of the chest. No evidence-based medical therapy exists for PVOD at present and lung transplant remains the preferred definitive therapy for eligible patients. We present a case of autopsy confirmed MMC induced PVOD in a patient with metastatic anal cancer.

Keywords: Anal cancer; Mitomycin-C; Pulmonary arterial hypertension; Pulmonary hypertension; Pulmonary vasodilators; Pulmonary veno-occlusive disease; Respiratory failure.

Publication types

Case Reports