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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Secondary spontaneous pneumothorax always develops secondary to underlying lung disease&#46; Although its occurrence due to cancer is rare&#44; it is mainly related to sarcomas&#46; Bilateral pneumothorax is less common&#46; Pazopanib&#44; used in the treatment of sarcoma patients&#44; is also a cause of pneumothorax&#46; Pazopanib&#44; a tyrosine kinase inhibitor&#44; is frequently used for renal cell carcinoma&#44; pancreatic neuroendocrine tumors&#44; and especially soft tissue sarcomas&#46; Pneumothorax cases due to pazopanib have been reported in the literature&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1&#44;2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">An 18-year-old male patient was admitted to the hospital with a palpable approximately 10<span class="elsevierStyleHsp" style=""></span>cm mass lesion on the lateral side of the gastrocnemius muscle of the left lower extremity&#46; The mass of the patient who did not detect distant metastases as a result of positron emission tomography &#40;PET&#47;CT&#41; was surgically excised&#46; As a result of the pathological evaluation of the material removed after the operation&#44; it was reported that the mass was synovial sarcoma&#46; Six courses of IMA &#40;ifosfamide&#44; mesna&#44; adriamycin&#41; treatment was planned&#46; Six months after the completion of adjuvant therapy&#44; multiple lung nodules were detected on thoracic computed tomography &#40;CT&#41;&#46; New systemic treatment was planned for the patient for recurrent synovial sarcoma&#46; Primary granulocyte colony-stimulating factor &#40;G-CSF&#41; prophylaxis with gemcitabine and docetaxel treatment was planned as second-line chemotherapy&#46; Despite the primary prophylaxis&#44; the patient could not tolerate chemotherapy due to deepening bi-cytopenia&#44; and the patient&#39;s systemic treatment was discontinued due to toxicity&#46; Pazopanib was started as a third-line treatment&#46; The radiologic evaluation was performed after 3 months of treatment in the patient&#44; who did not detect any toxicity with pazopanib treatment and did not have any complaints&#46; Bilateral significant pneumothorax was detected in the CT performed to evaluate the response&#46; Diffuse bilateral pneumothorax is shown in <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#46; Despite bilateral significant pneumothorax&#44; the patient did not have any clinical deterioration&#46; The patient was treated with tube thoracostomy and he was discharged after five days of hospitalization&#46; Pazopanib was restarted at 400<span class="elsevierStyleHsp" style=""></span>mg&#47;day for two weeks after discharge&#46; Systemic treatment of the patient who developed pneumothorax again after one week of pazopanib use was completely discontinued&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Soft tissue sarcomas metastasize quite frequently&#46; The lung is an important site of metastasis&#46; Unfortunately&#44; treatment options are limited in metastatic soft tissue sarcomas&#46; Pazopanib is an effective treatment option for these patients&#46; In a pre-approved clinical study of pazopanib for metastatic soft tissue sarcoma&#44; the incidence of pneumothorax during pazopanib treatment was reported to be approximately 2&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> However&#44; higher pneumothorax rates &#40;&#8764;10&#37;&#41; have also been reported in more recent studies&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> The mechanism of secondary pneumothorax arising from lung metastases is not clear&#46; However&#44; various theories such as tumor necrosis&#44; check valve and tumor embolism have been reported&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> In addition&#44; it is well known that angiogenesis inhibitors cause tumor necrosis and cavitation in lung lesions&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> Pazopanib can also cause pneumothorax by using this mechanism of action&#46; Especially in sarcoma patients with diffuse lung metastases&#44; routine lung examination and chest X-ray should be planned even if there are no symptoms while using pazopanib treatment&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0020" class="elsevierStylePara elsevierViewall">No funders pertaining to this article&#46;</p></span></span>"
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