Intravesical mitomycin-C-induced interstitial pneumonia. 2010

Hiroshi Wada, and Yasutaka Nakano, and Hideto Yamada, and Tatsuyoshi Saiga, and Akira Yamanaka, and Naoki Sakai
Division of Respiratory Medicine, Department of Internal Medicine, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, Japan. hwada@belle.shiga-med.ac.jp

An 84-year-old man with no evidence of pre-existing interstitial pneumonia developed fatal interstitial pneumonia and respiratory failure that could only be explained as an adverse effect of intravesical mitomycin C chemotherapy. He had undergone transurethral resection of bladder cancer 3 times, followed by intravesical mitomycin C chemotherapy 1 month later. He had received intravesical mitomycin C chemotherapy every week for 2 months, and he had complained of dyspnea on exertion 5 days before the last intravesical mitomycin C chemotherapy session. Interstitial infiltration was detected in both the upper and lower lobes of the left lung on the day of the last instillation of mitomycin C. Despite discontinuation of mitomycin C and administration of methylprednisolone, his condition deteriorated and he died. Diagnostic evaluation of other causes of pneumonia, including infection and collagen-vascular diseases, was negative. The autopsy demonstrated diffuse alveolar damage in the lung; there were no remarkable findings in other organs. To our knowledge, this is the first pathologically confirmed case of fatal interstitial pneumonia due to intravesical mitomycin C chemotherapy.

UI MeSH Term Description Entries
D008297 Male Males
D001749 Urinary Bladder Neoplasms Tumors or cancer of the URINARY BLADDER. Bladder Cancer,Bladder Neoplasms,Cancer of Bladder,Bladder Tumors,Cancer of the Bladder,Malignant Tumor of Urinary Bladder,Neoplasms, Bladder,Urinary Bladder Cancer,Bladder Cancers,Bladder Neoplasm,Bladder Tumor,Cancer, Bladder,Cancer, Urinary Bladder,Neoplasm, Bladder,Neoplasm, Urinary Bladder,Tumor, Bladder,Tumors, Bladder,Urinary Bladder Neoplasm
D002278 Carcinoma in Situ A lesion with cytological characteristics associated with invasive carcinoma but the tumor cells are confined to the epithelium of origin, without invasion of the basement membrane. Carcinoma, Intraepithelial,Carcinoma, Preinvasive,Intraepithelial Neoplasms,Neoplasms, Intraepithelial,Intraepithelial Carcinoma,Intraepithelial Neoplasm,Neoplasm, Intraepithelial,Preinvasive Carcinoma
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000283 Administration, Intravesical The instillation or other administration of drugs into the bladder, usually to treat local disease, including neoplasms. Bladder Drug Administration,Drug Administration, Bladder,Instillation, Bladder,Intravesical Drug Administration,Administration, Intravesical Drug,Injections, Intravesical,Intravesical Administration,Intravesical Injection,Intravesical Instillation,Administration, Bladder Drug,Administrations, Bladder Drug,Administrations, Intravesical,Administrations, Intravesical Drug,Bladder Drug Administrations,Bladder Instillation,Bladder Instillations,Drug Administration, Intravesical,Drug Administrations, Bladder,Drug Administrations, Intravesical,Injection, Intravesical,Instillation, Intravesical,Instillations, Bladder,Instillations, Intravesical,Intravesical Administrations,Intravesical Drug Administrations,Intravesical Injections,Intravesical Instillations
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D000903 Antibiotics, Antineoplastic Chemical substances, produced by microorganisms, inhibiting or preventing the proliferation of neoplasms. Antineoplastic Antibiotics,Cytotoxic Antibiotics,Antibiotics, Cytotoxic
D016685 Mitomycin An antineoplastic antibiotic produced by Streptomyces caespitosus. It is one of the bi- or tri-functional ALKYLATING AGENTS causing cross-linking of DNA and inhibition of DNA synthesis. Mitomycin C,Ametycine,Mitocin-C,Mitomycin-C,Mutamycin,NSC-26980,Mitocin C,MitocinC,NSC 26980,NSC26980
D017563 Lung Diseases, Interstitial A diverse group of lung diseases that affect the lung parenchyma. They are characterized by an initial inflammation of PULMONARY ALVEOLI that extends to the interstitium and beyond leading to diffuse PULMONARY FIBROSIS. Interstitial lung diseases are classified by their etiology (known or unknown causes), and radiological-pathological features. Diffuse Parenchymal Lung Disease,Diffuse Parenchymal Lung Diseases,Interstitial Lung Disease,Interstitial Lung Diseases,Pneumonia, Interstitial,Pneumonitis, Interstitial,Interstitial Pneumonia,Interstitial Pneumonias,Interstitial Pneumonitides,Interstitial Pneumonitis,Lung Disease, Interstitial,Pneumonias, Interstitial,Pneumonitides, Interstitial
D017809 Fatal Outcome Death resulting from the presence of a disease in an individual, as shown by a single case report or a limited number of patients. This should be differentiated from DEATH, the physiological cessation of life and from MORTALITY, an epidemiological or statistical concept. Fatal Outcomes,Outcome, Fatal,Outcomes, Fatal

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