Endotracheal-endobronchial metastases: report of 14 cases

ABSTRACT

Endotracheal-Endobronchial Metastases [EEM] secondary to extrapulmonary neoplasm are rare. Since 1989 we have encountered 14 patients with EEM. EEM were defined as documented extra pulmonary neoplasm metastatic to subsegmental or more proximal central bronchi in a bronchoscopically visible range. The developmental modes were described on the basis of classifying categories of Kiryu. The primary tumors included breast cancer [4 cases including 3 women, 1 man], colorectal carcinoma 1, renal cell carcinoma 1, embryonal cell carcinoma of testis1, uterine cervix carcinoma 2, melanoma 1, osteogenic sarcoma 2, papillary thyroid carcinoma 1 and prostatic sarcoma 1. The chest roentgenographic findings were collapse 5, parenchyma mass 5, multiple nodule 2 and hilar enlargement 2. Median interval from diagnosis of primary tumor was 39.5 months. Endobronchial lesions were detected by bronchoscopy and their metastatic nature was confirmed histopathologically in all patients. Six patients were treated with external radiotherapy, while 6 patients had chemotherapy and 2 patients underwent surgical resection of metastasis. The cases we have reported are similar to those found in the literature, regarding their clinical and roentgenographic presentation. Local treatment is effective for palliating symptoms. All patients with extra pulmonary malignant tumor who are suspected to have pulmonary metastasis should undergo bronchoscopy to diagnose end bronchial metastasis and to differentiate it from primary lung cancer