Lung Cancer and Pneumothorax

Abstract

To the Editor.— In their recent case report Hyde and Hyde (239:1421, 1978) stress the rarity of the association of pneumothorax with lung cancer and attempt to dissuade us from investigations to exclude malignant neoplasms. Their statement that this association is practically confined to those patients older than 40 years is simply not true, unless the authors are restricting themselves to primary bronchogenic carcinomas. If this be the case, the statement is self-evident, since primary lung cancer itself is rare in patients younger than 40 years. In fact, pneumothorax occurs more commonly with secondary malignant disease of the lungs, particularly metastases from bone sarcomas, and this is nearly always seen in those younger than 40 years. At least 68 cases of pneumothorax with primary lung cancer have been reported, and a review of the literature discloses 86 cases with metastatic disease. I am surprised that the authors have seen only