Bleomycin-induced pneumomediastinum in a young man with testicular cancer

Abstract Background The presence of bleomycin-induced pneumomediastinum (BIP) in patients with germ cell tumors (GCT) is an uncommon clinical variant within the spectrum of the lung toxicity associated with this drug. The incidence of BIP is currently unknown due to the rarity of this presentation. Case description We present the case of a 21-year-old man who presented with good-risk recurrent disease from a germ cell tumor two years after orchiectomy due to disease limited to the testis. BEP was planned for 3 cycles as a treatment schedule. After administration of 30 IU of bleomycin, he developed pneumomediastinum associated with respiratory symptoms. After 4 days of surveillance with conservative management, the patient had a good response. Conclusions To our knowledge, we present the first case of BIP after a single standard dose of bleomycin in a patient with testicular cancer. Choosing the patient who would benefit most from bleomycin to perform individualized treatment could reduce the incidence of toxicity associated with this drug in patients with GCT. Special attention should be given to respiratory symptoms during treatment schemes containing bleomycin.