Résumé
A 39-year-old woman was admitted to our hospital because of her chronic cough. She had undergone modified radical mastectomy for breast cancer 7 year before admission. A chest radiograph showed collapse of the left upper lobe (LUL) and computed tomography of the chest revealed a mass in the proximal portion of the LUL bronchus and distal atelectasis. Bronchoscopy showed obstruction of the LUL bronchus. The microscopic examination showed findings consistent with breast cancer with the same immunohistochemical features for the hormone receptors, as compared to those features of the previously resected tumor. Positron emission tomography showed increased fluorodeoxyglucose uptake only in the LUL. Left upper lobectomy was performed and she is now undergoing systemic chemotherapy. We report here on this rare case to emphasize that when a patient with a history of breast cancer complains of respiratory symptoms, and even though the patient was treated curatively a long time ago, we should suspect the possibility of endobronchial metastasis.
Sujets)
Adulte , Femelle , Humains , Région mammaire , Tumeurs du sein , Bronches , Bronchoscopie , Toux , Tumeurs du poumon , Mastectomie radicale modifiée , Métastase tumorale , Tomographie par émission de positons , Atélectasie pulmonaire , ThoraxRésumé
Lung parenchyma is a common organ for metastases of extrathoracic tumors, but endobronchial metastasis is very rare. In this report, we present a case of endobronchial metastases from renal cell carcinoma (RCC), and this was managed by performing operative resection. A 63-year-old man presented with frequent dry cough; he had previously undergone left nephrectomy and postoperative chemotherapy for grade 2 RCC eight years ago. Computed tomography and bronchoscopy showed an endobronchial tumor from the left lower lobe bronchus to the second carina, and this mass was diagnosed as a necrotic tissue with chronic inflammation at biopsy. During the operation, the mass was revealed to be a metastatic renal cell carcinoma on the frozen section diagnosis and there was no mucosal invasion on the resection margin of the left lower lobe bronchus. We performed lobectomy of the left lower lobe with systemic dissection of the mediastinal lymph nodes. The final histopathologic diagnosis of the endobrochial mass was metastatic RCC and any mediastinal lymph node metastasis was not found. The patient was discharged on postoperative day 10 without any postoperative complications.
Sujets)
Humains , Adulte d'âge moyen , Biopsie , Bronches , Bronchoscopie , Néphrocarcinome , Coupes minces congelées , Inflammation , Noeuds lymphatiques , Métastase tumorale , Néphrectomie , Complications postopératoiresRésumé
Endobronchial metastasis (EBM) secondary to extrathoracic malignancies is rare among the various modes of pulmonary metastases. Of the many types of extrathoracic tumors capable of EBM, only one case of EBM from hepatocellular carcinoma has been reported, but radiologic findings were not described. We present the radiologic findings of surgically proven EBM in a patient with hepatocellular carcinoma. A chest radiograph revealed a tubular mass-like opacity in the right suprahilar region combined with mild volume decrease of the right upper lobe. Fiberoptic bronchoscopy had erroneously led to a diagnosis of endobronchial aspergilloma. The metastatic lesion was manifested as a branching pattern of enhanced endobronchial mass at the anterior segment of the right upper lobe on computed tomography.
Sujets)
Femelle , Humains , Adulte d'âge moyen , Tumeurs des bronches/diagnostic , Carcinome hépatocellulaire/diagnostic , Tumeurs du foie/anatomopathologie , Radiographie thoracique , TomodensitométrieRésumé
Pumonary metastases from renal cell carcinoma are common, but metastases in the large brohchi are uncommon and recurrence of renal cell carcinoma 10 years after primary resection is rare case. When endobronchial metastasi s do present they usually simulate, clinically and radiologically, bronchial carcinoma. We report a 67-year-old man with endobronchial metastasis of renal cell carcinoma 10 years after radical nephrectomy with a brief review of the literature.
Sujets)
Sujet âgé , Humains , Carcinome bronchogénique , Néphrocarcinome , Métastase tumorale , Néphrectomie , RécidiveRésumé
Endobronchial metastasis from uterine cervix cancer defines a bronchoscopically visible nonpulmonary neoplasm metastatic to the bronchus and histologically identical to cervix cancer. Endobronchial metastasis of uterine cervix cancer is rare, therefore, it is difficult to diagnose without pulmonary symptoms or abnormal radiological findings. Moreover, endobronchial metastasis of a nonpulmonary neoplasm is difficult to differentiate from a primary pulmonary neoplasm. The incidence of endobronchial metastasis is increasing because of the regular use of fiberoptic bronchoscopy and the longer survival of cancer patients. This study describes our experience of two patients with pulmonary symptoms and abnormal radiologic findings during the follow up of uterine cervix cancer, who were diagnosed as having endobronchial metastasis from uterine cervix cancer, and includes a brief review of related articles.
Sujets)
Adulte , Femelle , Humains , Tumeurs des bronches/radiothérapie , Bronchoscopie , Tumeurs du col de l'utérus/anatomopathologie , Adulte d'âge moyen , Soins palliatifsRésumé
BACKGROUND: The lung is the most common site for a metastasis of extrapulmonary malignant tumors. however, reports on an endobronchial metastasis are rare. An endobronchial metastasis is defined as a documented extrapulmonary neoplasms metastatic to the segmental or more proximal central bronchus within a bronchoscopically visible range. The purpose of this study was to define the clinical characteristics of an endobronchial metastasis of extrapulmonary malignancies. METHODS: The clinical features and treatment outcomes of 27 endobronchial metastatic cancer cases were reviewed from June, 1991 to May, 2001 in the Severance Hospital. RESULTS: The patients' age ranged from 18 to 75. There were 17 men and 10 women. The primary tumors included the colorectum in 7, the uterine cervix in 4, the stomach and the breast in 3 patients each, and an osteosarcoma in 2 patients. The main complaint of most patients was coughing and a chest X-ray revealed a hilar mass, a parenchymal nodule, and an atelectasis. The mean recurrence interval time was 45.5 months. The median and mean survival times were 10 and 12.3 months, respectively. CONCLUSION: An endobronchial metastasis is an ominous finding, and is associated with advanced-stage disease. It requires differential diagnosis with a primary bronchogenic carcinoma. If atypical clinical features are present or an atypical cell type is discovered by a biopsy of the lesion in the lung mass, the appropriate diagnostic studies should be undertaken.
Sujets)
Femelle , Mâle , Humains , Diagnostic différentiel , Biopsie , Métastase tumoraleRésumé
Malignant melanoma is a highly malignant form of cutaneous cancer derived from melanocytes. The lesion frequently metastasizes to the lymph nodes, lung, liver and bone. However, an endobronchial metastasis and a primary malignant melanoma of the lung are quite rare. We report a case of an unknown primary malignant melanoma with a pulmonary and endobronchial metastasis in a 34 years old male. He complained of coughing and black-colored sputum. Abnormal skin and mucosal lesions were not found during a physical examination. A chest X-ray revealed multiple nodular masses in both lung fields. A flexible bronchoscopy showed two yellowish small nodules at the entry of left lower bronchus. Vimentin, the S-100 protein, and HMB-45 stain positive melanoma cells were detected at the bronchoscopic biopsy specimen.
Sujets)
Biopsie , Métastase tumoraleRésumé
Malignant melanoma is a highly malignant form of cutaneous cancer derived from melanocytes. The lesion frequently metastasizes to the lymph nodes, lung, liver and bone. However, an endobronchial metastasis and a primary malignant melanoma of the lung are quite rare. We report a case of an unknown primary malignant melanoma with a pulmonary and endobronchial metastasis in a 34 years old male. He complained of coughing and black-colored sputum. Abnormal skin and mucosal lesions were not found during a physical examination. A chest X-ray revealed multiple nodular masses in both lung fields. A flexible bronchoscopy showed two yellowish small nodules at the entry of left lower bronchus. Vimentin, the S-100 protein, and HMB-45 stain positive melanoma cells were detected at the bronchoscopic biopsy specimen.
Sujets)
Biopsie , Métastase tumoraleRésumé
An endobronchial metastasis is defined as a subsegmental or a more proximal central bronchial metastasis of a nonpulmonary neoplasm in the bronchoscopically visible range. However, the frequencies of endobronchial metastasis range from 2 to 50% of pulmonary metastases from extrathoracic neoplasms by a different difinition of an endobronchial metastasis. Primary neoplasms of an endobronchial metastasis including breast cancer, colon cancer, renal cell carcinoma, and ovarian cancer are relatively common. However, an endobronchial metastasis arising from thyroid cancer, parotid gland tumor, bone tumor, bladder cancer, and stomach cancer has only rarely been reported in the literature. Here we report a case of an endobrochial metastases from a hepatocellular carcinoma
Sujets)
Tumeurs du sein , Carcinome hépatocellulaire , Néphrocarcinome , Tumeurs du côlon , Métastase tumorale , Tumeurs de l'ovaire , Glande parotide , Tumeurs de l'estomac , Tumeurs de la thyroïde , Tumeurs de la vessie urinaireRésumé
Carcinoma of the prostate is a common malignancy affecting elderly men. Lung metastasis from prostate cancer occurs frequently, but tumor metastasis to the central bronchi that clinically mimics primary bronchogenic carcinoma are very rare. We report a 73-year old man with endobronchial metastasis from prostatic carcinoma presented with respiratory symptom cough. Diagnosis of issues taken from materials which were used for bronchoscopic biopsy and prostate biopsy and immunohistochemical staining for prostate specific antigen(PSA) confirmed a case of endobronchial metastasis from prostatic carcinoma. Hormonal therapy(LHRH agonist) was applied to this patient.