Androgen deprivation
therapy, which is the standard
treatment for metastatic
prostate cancer, includes nonsteroidal antiandrogenic
drugs, such as
flutamide, nilutamide and bicalutamide. Of them, bicalutamide rarely induces
interstitial pneumonia. We
report a case of bicalutamide-induced
interstitial pneumonia. A 68-year old
male diagnosed with
prostate cancer and multiple
bone metastases presented with dry
cough and low grade
fever for 3 days. He had taken bicalutamide (50 mg/day) for 13 months. High resolution computed
tomography revealed ground
glass opacity in his right upper
lung. The
laboratory studies showed no
eosinophilia in the
serum and
bronchoalveolar lavage fluid. Despite the use of
antimicrobial agents for 2 weeks, the extent of the
lung lesions increased to the left upper and right lower
lung. He had no
environmental exposure,
collagen vascular disease and microbiological causes. Under the suspicion of bicalutamide-induced
interstitial pneumonia, bicalutamide was stopped and
prednisolone (1 mg/kg/day) was initiated. The symptoms and radiologic
abnormalities were resolved with residual minimal
fibrosis.