Steroid-Resistant Docetaxel-Induced Pneumonitis With Air Leak Syndrome: A Rare but Fatal Complication
Year: 2026
Type: article
Study design: Case Report
Abstract: Docetaxel, a taxane commonly used in the treatment of metastatic prostate cancer, can occasionally cause pulmonary toxicity, most often presenting as interstitial pneumonitis. Although most patients respond favourably to corticosteroid therapy, a small subset develops a rapidly progressive, steroid-resistant pneumonitis characterised by diffuse alveolar damage, air leak syndromes, and high mortality. This report describes the case of a 74-year-old man with oligometastatic prostate adenocarcinoma who developed such a severe, steroid-refractory pneumonitis after his fifth cycle of docetaxel. Despite prompt drug withdrawal, escalation to high-dose intravenous methylprednisolone, and intensive supportive care, his respiratory status worsened. He subsequently developed pneumothorax, pneumomediastinum, and surgical emphysema. Extensive investigations ruled out alternative causes of respiratory deterioration such as infection, heart failure, vasculitis, and pulmonary embolism. This fatal case illustrates the rare but devastating cytotoxic form of docetaxel-induced lung injury and emphasises the importance of maintaining a high index of suspicion, initiating early diagnostic evaluation, and considering adjunctive immunomodulatory treatment strategies when corticosteroids fail.
Source: Cureus
Authors: Innes Turral, Rupak Kundu
Institution: Yeovil District Hospital
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7124829329