Abstract

Methotrexate is a commonly prescribed antineoplastic and immune modulating compound that has gained wide acceptance in the management of rheumatoid arthritis, psoriasis, sarcoidosis and a number of neoplastic disorders. High dose methotrexate with folinic acid rescue is widely used to treat osteosarcoma, which predominantly afflicts children. Although generally considered safe and easy to use, methotrexate has been associated with a number of adverse reactions. Serious toxicity may affect the lungs, liver and bone marrow. Pulmonary complications of methotrexate may be classified as inflammatory, infectious and possibly neoplastic. We describe a patient with osteosarcoma who presented with leg pain and subsequently developed a spontaneous pneumothorax during treatment with Methotrexate. © 2007 Asian Network for Scientific Information.