Spontaneous pneumothorax due to bronchopleural fistula following reirradiation for locoregionally recurrent squamous cell lung cancer

Pneumothorax is defined as air in the pleural cavity 1. Primary spontaneous pneumothorax occurs in the absence of clinically apparent lung disease, whereas secondary spontaneous pneumothorax is a complication of underlying lung disease 1, 2, 3. Chronic obstructive pulmonary disease and pneumocystis pneumonia are the most common causes of secondary spontaneous pneumothorax. Approximately 70% of secondary spontaneous pneumothorax cases are associated with chronic obstructive pulmonary disease 2, whereas less than 5% of cases are a result of malignancy 4. One mechanism underlying spontaneous pneumothorax in the case of malignancy is the development of a bronchopleural fistula (BPF), a channel between the bronchial and pleural space created by direct tumor invasion into the pleural space, tumor necrosis as a result of treatment, or vascular occlusion within a tumor itself 5. In the current report, we present a case of BPF during reirradiation of squamous cell lung cancer.