The occurrence of spontaneous pneumothorax in primary lung cancer patients is infrequent. No exact theory could explain its mechanism of association. It could be either a primary manifestation or a late complication of primary lung cancer. The aim of this study is to analyze the association of the spontaneous pneumothorax with the primary lung cancer. A retrospective revision of patients’ files that presented with spontaneous pneumothorax and admitted at the Cardiothoracic Surgery Department during the period between January 2000 and January 2018 was done. Twenty-three patients were included in this study. Seventy-four percent of them were males (n = 17). Age ranged between 48 and 77 years (62.3 ± 7.3 years). Twelve patients (52%) were known to have advanced primary lung cancer, while seven patients (30%) had SPnx as a primary presentation for the primary lung cancer that was discovered during radiological assessment for SPnx. The remaining four patients had SPnx and were treated via surgery. In three of them, bullectomy and pleurodesis was performed; the postoperative histo-pathological examination of excised bullae revealed a primary non-small cell lung cancer (NSCLC). While in one patient, who had bullectomy, the primary lung cancer was discovered accidently during surgery. Pneumothorax as a first manifestation for lung cancer is infrequent. Its relation to the prognosis has not been yet clear. Recurrent spontaneous pneumothorax in old, heavy smoker patient, or emphysema patient should raise the suspicion for the possibility of association of lung carcinoma.

中文翻译：

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与原发性肺癌相关的自发性气胸的回顾性研究

原发性肺癌患者很少发生自发性气胸。没有确切的理论可以解释其关联机制。它可能是原发性肺癌的主要表现或晚期并发症。这项研究的目的是分析自发性气胸与原发性肺癌的关系。对2000年1月至2018年1月期间自发性气胸并在心胸外科接受治疗的患者档案进行了回顾性修订。本研究包括23例患者。其中有74％是男性（n = 17）。年龄介于48至77岁（62.3±7.3岁）之间。已知十二名患者（52％）患有晚期原发性肺癌，而有7位患者（30％）将SPnx作为原发性肺癌的主要表现，这是在对SPnx进行放射学评估时发现的。其余四名患者患有SPnx，并通过手术治疗。其中三个进行了牛切除术和胸膜固定术。切除大疱的术后组织病理学检查显示原发性非小细胞肺癌（NSCLC）。在一名进行了牛切除术的患者中，在手术期间意外发现了原发性肺癌。气胸是肺癌的首发表现，很少见。其与预后的关系尚不清楚。老年，重度吸烟者或肺气肿患者复发性自发性气胸应引起怀疑与肺癌相关的可能性。