Is tin fume exposure benign or not? Two case reports.

Stannosis is a non-fibrotic form of pneumoconiosis in which tin-oxide is accumulated in pulmonary parenchyma as a result of inhalation of tin-oxide (stannic oxide) dust and fume. Chest radiograph shows numerous small very dense nodules in both lungs. Although radiological findings of stannosis were apparent, the patients were clinically in good condition, and pulmonary function test (PFT) values showed no disability. Case 1, 70-year-old man had exercise dyspnea for four years. He worked as a tinner for 40 years. A slight restriction was detected in his PFT. Diffused, small, dense, reticulonodular opacities were detected on chest X-ray. Thorax high resolution computerized tomography (HRCT) revealed dense, common noduler lesions, reticulation and honeycomb appearance. Case 2, the patient was a 50-year-old woman. She had been exposed tin fume for 33 years and never smoked. In PFT, a slightly low FEV1 value and a normal FVC value were detected. Diffused reticulonodular opacities were detected on chest X-ray. On thorax HRCT, ground glass densities in some areas, widespread interlobulary septal thickening, peribronchial thickening predominant in perihilar regions in both lungs and subpleural milimetric nodular densities were observed in the upper and middle lobe of the right lung. Two patients who exposed to tin fume are described. However, contrary to what is expected, both patients clinically deterioted and died as a result of respiratory failure.