Lung toxicity in a patient treated with sunitinib.

While pleural effusions are common, those secondary to pancreaticopleural fistulae are rare, most often occurring in patients with a history of chronic pancreatitis or alcoholism [1]. In this case the fistula formed from an IPMN. These are extremely rare entities that represent 10% of pancreatic cysts. They can show varying degrees of dysplasia with recurrence being rare in noninvasive types (,8%) versus invasive types (50–65%) [2]. Fistulae to abdominal viscera have been described previously [3]; however, to our knowledge, they have not been known to fistulate to the pleural cavity.