Mitomycin-induced pulmonary toxicity: A case report and review of literature

Mitomycin is an alkylating chemotherapeutic agent that is used for the treatment of anal cancers. Pulmonary toxicities associated with mitomycin are broad and have been well described and range from acute bronchospasm, diffuse alveolar damage, interstitial pneumonitis, pleural disease to pulmonary veno-occlusive disease^{1, 2}. The following is a case of a 63-year-old woman who suffered mitomycin-related acute lung injury 14 days after receiving the first dose. She had escalating oxygen needs, which eventually required mechanical ventilation. Treatment included high-dose steroids and broad-spectrum antibiotics; however, her respiratory function never recovered, and she died from cardiopulmonary arrest from hypoxia. This case highlights that patients undergoing therapy with mitomycin who develop respiratory symptoms should have this lung toxicity considered and the need for further research to recognize and treat this rare complication.