Illustration of a fatal radiation-induced lung aneurysm: Is central lung stereotactic radiotherapy to be banned?

Cancer Radiother. 2019 Dec;23(8):926-929. doi: 10.1016/j.canrad.2019.05.016. Epub 2019 Oct 11.

Abstract

Stereotactic body radiation therapy is still controversial for inoperable patients with central lung lesion. We report the case of a 59-year-old woman with previous history of head and neck squamous cell carcinoma who was treated by lung stereotactic body irradiation for an inoperable lymph node in station 10R. One year after, a fibroscopy showed a necrosis of the right main bronchus mucosae and the CT showed a radio-induced aneurysm protruding into the right inferior lobular bronchus. The patient eventually died a few hours later with a massive haemoptysis. This case highlights the potential toxicity of central lung stereotactic body radiation therapy and raises the question of its legitimacy.

Keywords: Aneurysm; Anévrisme; Central tumour; Haemoptysis; Hémoptysie; Long-term toxicity; Lung lesion; Lésion pulmonaire; SBRT; Stéréotaxie; Toxicité à long terme; Tumeur centrale.

Publication types

  • Case Reports

MeSH terms

  • Aneurysm / diagnostic imaging
  • Aneurysm / etiology*
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Carcinoma, Non-Small-Cell Lung / radiotherapy*
  • Carcinoma, Squamous Cell / therapy
  • Dose Fractionation, Radiation
  • Female
  • Head and Neck Neoplasms / therapy
  • Humans
  • Lung Neoplasms / pathology
  • Lung Neoplasms / radiotherapy*
  • Lymphatic Irradiation / adverse effects*
  • Lymphatic Irradiation / methods
  • Middle Aged
  • Neoplasms, Unknown Primary / therapy
  • Pulmonary Artery / diagnostic imaging
  • Pulmonary Artery / radiation effects*
  • Radiosurgery / adverse effects*
  • Radiosurgery / methods