BLEOMYCIN AND CYCLOPHOSPHAMIDE TOXICITY SIMULATING METASTATIC NODULESTO THE LUNGS IN CHILDHOOD-CANCER

Two pediatric oncology patients with Ewing's sarcoma and one with mixe d germ cell tumor were treated with drug regimens that included bleomy cin or cyclophosphamide. Despite progress to apparently complete remis sion, all manifested pulmonary nodules on computed tomography during o r at the end of treatment. Thoracoscopic biopsy to confirm metastasis revealed instead fibrotic lesions apparently attributable to bleomycin or cyclophosphamide. After cessation of chemotherapy, the pulmonary l esions resolved and all three patients sustained their remissions. The ease histories and comments on the diagnosis and management of pulmon ary nodules are reviewed.