Isolated Endobronchial Metastasis of Breast Cancer Successfully Managed With Multimodal Treatment

Isolated endobronchial metastases of breast cancers, without other visceral metastatic involvement, are exceptional. We report here an observation of isolated endobronchial metastasis discovered 18 months after complete treatment of breast carcinoma. The endobronchial metastasis was revealed by an incoercible cough and hemoptysis. A bronchoscopy revealed a budding tumor process obstructing the right stem bronchus and a biopsy was performed. The anatomopathological and immunohistochemical analysis confirmed the metastatic nature of the endobronchial tumor. The patient received treatment with palbociclib and aromatase inhibitors. Two years after radiotherapy and under hormone treatment, the patient is in complete remission of her breast cancer and endobronchial metastasis. Emerging research suggests that oligometastatic breast cancer carries a superior prognosis. We believe that patients with oligometastatic breast cancer should be treated with curative intent, including ablative therapy to all sites of disease if it can be safely accomplished. This approach may offer an additional chance for prolonged survival.

Endobronchial metastasis of hepatocellular carcinoma treated with Lenvatinib: A case report

Endobronchial metastasis (EBM) of hepatocellular carcinoma (HCC) is rare though HCC often metastasizes to the lungs. In this case report, a 74-year-old man with a history of HCC with chronic hepatitis C experienced hemoptysis and a dry cough. During immunotherapy for postoperative recurrent HCC, chest computed tomography (CT) revealed soft tissue shadows in the right upper and lower lobe bronchi, and we pathologically diagnosed as EBM of HCC using bronchoscopy. Although the prognosis of HCC with EBM is poor, lenvatinib, a tyrosine kinase inhibitor, was administered and resulted in improved symptoms, decreased tumour markers, and reduced EBM shadows on chest CT scans. To the best of our knowledge, this is the first case of lenvatinib monotherapy for EBM of HCC. It is important to perform a bronchoscopy for early diagnosis of EBM, followed by lenvatinib treatment.

Endobronchial Metastasis with Bloody Sputum 20 Years after Complete Resection of type A Non-Invasive Thymoma

Masaoka stage I type A thymomas rarely recur. We report the case of an 82-year-old man who developed endobronchial metastasis after thymothymectomy for Masaoka stage I type A thymoma. Twenty years after surgery, the patient developed bloody sputum, and chest computed tomography revealed a neoplasm obstructing the right upper lobe bronchus of the lung with enlarged mediastinal lymph nodes. He underwent right upper lobectomy and mediastinal lymph node dissection. Although preoperative pathological diagnosis was squamous cell carcinoma of the lung, postoperative histopathology revealed endobronchial metastasis of the thymoma. Nine years later, at age 89, the patient is alive and well.

Endobronchial Metastasis of Renal Carcinoma: A Case Report and Review of Previous Literature

The definition of endobronchial metastasis (EBM) lacks clarity because it is currently based on the judgments of surgeons; it is rare in patients with nonpulmonary malignancies. Although EBM represents an advanced stage of malignancy, it does not necessarily indicate a poorer prognosis than that for its primary tumors. The present study defines EBM as bronchoscopy-visible lesions with histologically confirmed primary extrapulmonary tumors, excluding those primary lung tumors with involvement of the bronchial lumen. A bronchoscopy and biopsy provide strong proof for diagnosis. Complete surgical resection is the best choice for patients with EBM. This study analyzed the case of a 69-year-old male patient who had undergone a radical left nephrectomy several years previously after the identification of a bronchoscopy-visible lesion in the left main bronchus. The lesion was initially diagnosed as an angiogenic tumor but was eventually confirmed by surgical biopsy as EBM from the left kidney. After diagnosis, the patient underwent a left pneumonectomy. The analysis of this case focused on diagnosis, symptoms, radiographic findings, treatment, and prognosis. A review of the previous literature relating to EBM was also conducted.

Successful bronchial arterial infusion chemotherapy combined with radiotherapy for an endobronchial metastasis after resection of small cell lung cancer

Bronchial arterial infusion (BAI) chemotherapy has been reported to be an effective treatment option for centrally located early-stage squamous cell lung cancer (SCC) and has a favourable response rates for patients with stage III or IV or recurrent non-small cell lung cancer (NSCLC) without distant metastases who cannot tolerate standard chemotherapy. Here, we report a case of an 83-year-old male with a solitary polypoid endobronchial metastatic tumour in the left main bronchus one year and 10 months after video-assisted thoracoscopic surgery (VATS) combined segmentectomy (left S6 + S8a) for small cell lung cancer (SCLC), pT1bN0. He was treated with BAI of 100 mg of cis-Diamminedichloroplatinum/cisplatin (CDDP), followed by thoracic radiotherapy (56 Gy in 28 fractions). There was no recurrence for 2.5 years. BAI chemotherapy combined with radiotherapy seemed to be an effective salvage option for the treatment of solitary endobronchial metastases of SCLC in patients unfit for standard chemoradiotherapy.

Endobronchial metastasis from renal cell carcinoma as a reason for recurrent pulmonary infections

Endobronchial metastases (EBM) secondary to extrathoracic malignancies are very rare. Breast cancer, colorectal cancer and renal cell carcinoma represent the most common types of cancer leading to endobronchial metastases. They usually represent a late manifestation of other types of cancer and their prognosis is generally poor averaging a survival of 1-2 years in most case series. Due to their rarity, they remain a challenge for clinicians regarding whether they are primary lung tumors or not. This case report article intends to present a case of a young man with a left nephrectomy due to Clear-Cell Renal Cell Carcinoma, who developed EBM 7 years later and to summarize available data in the field. Furthermore, the utility of diathermic snare as a treatment approach for this entity is highlighted.

Late Endobronchial Pulmonary Metastasis in a Patient with Breast Cancer

The lung is a common location for malignant metastases. However, endobronchial metastases from nonpulmonary neoplasms are rare. Metastatic breast cancer usually occurs in 2-3 years of the disease course. A 65-year-old woman visited our hospital for the evaluation of dry cough. The patient had a history of breast cancer, which was treated with modified radical mastectomy and axillary dissection 10 years ago; she was then treated with aromatase inhibitor for 5 years. Chest X-ray revealed right hilum enlargement. Thorax computed tomography revealed a 35-mm diameter mass that was localized in the right hilum. Fiberoptic bronchoscopy was performed, and an endobronchial lesion was observed in the right main lobe carina. Pathological evaluation revealed that the mass was a metastasis of the invasive ductal carcinoma of the breast. Weekly paklitaxel chemotherapy was initiated because of the symptomatic disease. We reported the case of a patient with breast cancer who had an endobronchial metastasis. Her disease-free interval was 10 years. This case indicates that a long-term follow-up of breast cancer is necessary, and biopsies must be performed to make a final diagnosis when any suspicious hilum enlargement is observed.

[Initial manifestation and atypical site for metastatic synovial sarcoma in an immunocompetent adult patient: about a case and literature review]

Synovial sarcoma (SS) is a rare tumor. It is characterized by various sites of occurrence but rarely involves the chest. The tumor may be wrongly diagnosed as benign due to its slow growth. Less than 10% of patients present with metastatic cancer. Endobronchial metastases are exceptional. Immunohistochemical examination and cytogenetic analysis allow to distinguish it from other mesenchymal tumors. The presence of SYT-SSX fusion transcript allows the diagnosis. Surgery is used for localized tumors that can be treated with radiation therapy while chemiotherapy is used for metastatic tumors. The average rate of locoregional or metastatic recurrence two years after SS is 50%. We report the case of a 28-year old patient with metastatic SS characterized by its uncommon metastatic site. He presented with endobronchial metastasis revealing his disease, that had evolved for more than 2 years. The SS is life-threatening due to its slow and insidious growth. Prognosis is guarded. This study aimed to emphasize this atypical site for metastatic synovial sarcoma as well as to insist on the role of early diagnosis and treatment.

Transbronchial Dissemination of Squamous Cell Lung Cancer

We report a case of squamous cell lung cancer with transbronchial dissemination in a 73-year-old man. Bronchoscopic examination revealed multiple bronchial mucosal nodules that existed independently of one another. We reviewed 16 previous cases of endobronchial metastasis in lung cancer. All patients were men. Among the reports that described the smoking history, most patients were smokers (6/7), and the most frequent histological type of cancer was squamous cell carcinoma (11/17). Although hematogenous and lymphogenous routes have been reported as metastatic mechanisms, no previous cases involving transbronchial dissemination have been described. Transbronchial dissemination may be an alternative pathway of endobronchial metastasis.

Superficial-type endobronchial metastases from colon cancer: A case report

Certain internal malignancies, including colon cancer, can develop endobronchial metastasis. The present study reports a case of colon cancer with superficial-type endobronchial metastases in a 76-year-old male. Chest computed tomography revealed small masses and infiltrates in each lung, with bilateral hilar lymph node swelling. Superficial endobronchial tumors in each of the bronchi were unexpectedly found by bronchoscopic examination. A biopsy specimen obtained from the endobronchial tumor was diagnosed as colon cancer. Superficial-type endobronchial metastasis from colon cancer is extremely rare, however, such metastasis should be considered for patients who have a history of colon cancer. There should be no hesitation in performing a bronchoscopic biopsy as an additional examination.

Human papillomavirus type-16 positive endobronchial metastasis from uterine cervical cancer

Although the lung is the most common site of metastasis from extrapulmonary malignancies, endobronchial metastases (EBM) are relatively rare. EBM typically originate from breast, colorectal, or kidney cancer. EBM from uterine cervical cancer is relatively rare and is difficult to confirm. In this study, we report a case of EBM in a patient with previously treated uterine cervical cancer. In this case, differentiation of the EBM from primary bronchogenic carcinoma with clinical, radiological, and pathologic findings was difficult. As identical human papillomavirus (HPV)-16 DNA was detected in both the EBM and in previously resected tissues from the prior uterine cervical cancer, the patient was diagnosed with EBM from uterine cervical cancer. HPV genotyping may aid in discriminating EBM from primary bronchogenic carcinoma in patients with uterine cervical cancer.

Airway metastasis of small cell lung carcinoma: A rare presentation

Airway metastasis from primary lung carcinoma is rare and typically associated with non-small cell histology. While small cell lung cancer is a particularly aggressive form of cancer, few cases of endotracheal or endobronchial metastasis have been reported. Airway involvement can go undetected because of the spread along the perilymphatic drainage system with mostly submucosal involvement causing significant airway compromise before onset of symptoms. We present a patient with recurrent small cell lung cancer, presenting with wheezing, cough, and dyspnea as a result of metastasis to the trachea and bilateral bronchi without significant mediastinal or hilar lymphadenopathy. We discuss the related literature, as well as the suspected pathophysiology causing this unique presentation.

Endobronchial metastasis in a dog with sarcoma

A 3-year-old neutered male Australian Shepherd mix dog presented with metastatic soft tissue sarcoma arising from a primary tumor in the left lumbar fascia. Two separate metastases to the lungs were characterized by neoplasia within bronchiolar walls, which caused obstruction of the bronchiolar lumina and atelectasis of adjacent alveoli, a characteristic feature of endobronchial metastasis. Neoplastic cells of the primary lumbar neoplasm, metastatic pulmonary lesions, and additional widespread metastatic masses identified postmortem were similarly immunoreactive for vimentin, but non-immunoreactive for cytokeratin, cluster of differentiation 18, synaptophysin, chromogranin, and desmin. The present report describes a naturally occurring case of endobronchial metastasis in a dog.

Endobronchial metastasis of malignant melanoma, diagnosed by bronchoscopy--report of a case

Endobronchial metastasis occurs in about 2% to 5% of patients dying of solid tumors of extrathoracic origin. These metastatic tumors can simulate bronchogenic carcinoma and presenting symptoms include cough, hemoptysis, dyspnea and wheezing. In most cases of endobronchial metastasis, the histologic finding of the bronchoscope biopsy suggests the correct diagnosis. There are only a few reports of endobronchial metastasis from malignant melanoma. We report a case of malignant melanoma with endobronchial metastasis presenting with hemoptysis simulating primary bronchogenic carcinoma.