Tamoxifen-induced lung injury: a case report

Interstitial lung diseases (ILD) are one of the most frequent drug-induced disorders of the respiratory system. Drug-induced interstitial lung diseases (DIILD) account for 3% to 6% in the structure of all ILD. The diagnosis of DIILD requires the exclusion of other possible causes of ILD, especially in oncological and immunocompromised patients. The diagnostic challenges are associated with rare cases of drug-induced pneumopathy or with the use of several potentially relevant drugs, as well as in combination with radiotherapy in cancer patients.

The aim of the report was to demonstrate a rare clinical case requiring differential diagnosis between radiation pneumonitis and DIILD in a 53-year-old woman undergoing treatment for breast cancer. This case illustrates the difficulties in the differential diagnosis of tamoxifen-induced interstitial lung lesions. The diagnosis of tamoxifen-induced organizing pneumonia (OP) was made on the basis of exclusion of other causes, primarily infectious lesions, recurrent nature of symptoms, and X-ray picture of bilateral OP on repeated administration of tamoxifen.

Conclusion. An awareness and suspicion of DIILD, in particular the rare variant – tamoxifen-induced OP – allows to identify timely a causal relationship with taking the “responsible” drug and minimize the potential morbidity and risks of adverse evolution of DIILD.

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